Antiretroviral therapy in resource-limited settings: is there still a role for stavudine?

Abstract:

:Phanuphak et al. compared three strategies for first-line antiretroviral therapy in 150 Thai patients: initiating therapy with zidovudine (AZT), tenofovir disoproxil fumarate (TDF), or a 24-week lead-in phase with stavudine (d4T) followed by a switch to AZT. Those taking d4T had higher haemoglobin levels and CD4(+) T-cell counts without an increase in neuropathic symptoms, peripheral neuropathy or lipoatrophy compared with those on AZT. Because AZT is associated with more short-term side effects and toxicity than d4T, and because most d4T toxicity occurs only after long-term use, this approach may have advantages over initial use of AZT. However, TDF-based regimens, while more expensive, are more effective, better tolerated, less toxic, less likely to lead to cross-resistance, and possibly more cost-effective. The goal in resource-limited settings should be to move away from use of thymidine analogues in first-line regimens.

journal_name

Antivir Ther

journal_title

Antiviral therapy

authors

Gallant JE

doi

10.3851/IMP2498

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

1507-9

issue

8

eissn

1359-6535

issn

2040-2058

journal_volume

17

pub_type

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