Long-term Safety and Efficacy of Zidovudine in Patients With Advanced Human Immunodeficiency Virus Disease

Moore, Richard D.; Creagh-Kirk, Terri; Keruly, Jeanne C.; Link, G; Wang, Mei‐Cheng; Richman, Douglas D.; Chaisson, Richard E.

doi:10.1001/archinte.1991.00400050123023

Cited by 36 publications

(3 citation statements)

References 12 publications

(4 reference statements)

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“…As per the recent NACO (National AIDS Control Organisation) guidelines fixed dose combination of two NRTIs (AZT/stavudine?lamivudine) and one NNRTI (nevirapine/efavirenz) is recommended as the first line highly active antiretroviral therapy (HAARTs). Among them AZT is highly effective and the preferred NRTI in NACO sponsored anti retroviral therapy (ART) centers in India, but it is associated with several adverse effects like myelotoxicity, mitochondrial toxicity, myopathy and among them myelotoxicity is a major side effect [1]. The prevalence and incidence of AZT induced anaemia varies widely in different parts of the world [2,3] and also in different parts of India ranging from 5.42 % to 16.20 %.…”

Section: Introductionmentioning

confidence: 99%

High Incidence of Zidovudine Induced Anaemia in HIV Infected Patients in Southern Odisha

Dash

Meher

Hui

et al. 2014

Indian J Hematol Blood Transfus

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Zidovudine (AZT), a nucleoside reverse transcriptase inhibitor was the first breakthrough in AIDS therapy in 1990.This study was conducted with an aim to determine prevalence of AZT induced anaemia in HIV infected patients initiated on AZT containing anti retroviral therapy(ART) regimen and also to find out any risk factor for causing AZT induced anaemia. Study was carried out in ART centre, M.K.C.G, MCH, Berhampur between Jan 2009 and Dec 2011. HIV infected patients registered at ART centre were treated according to National AIDS Control Organisation (NACO) guidelines. Patients (n = 1221) with Hb [8 gm/dl were prescribed AZT based ART regimen. Patients having anaemia (\8 gm/dl) were excluded from the study. Correlation of baseline characteristics (age, sex, weight, Hb level, CD 4 count, World Health Organization (WHO) clinical stage) with risk of developing anaemia was also calculated. 178 (14.6 %) patients on AZT regimen developed anaemia. Patients with low CD 4 count were more prone to develop severe anaemia. Age, sex, weight, WHO clinical stage had no relation with development of anaemia. Incidence of AZT induced anaemia was very high and patients having low CD 4 count were more susceptible to develop anaemia.

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Section: Introductionmentioning

confidence: 99%

High Incidence of Zidovudine Induced Anaemia in HIV Infected Patients in Southern Odisha

Dash

Meher

Hui

et al. 2014

Indian J Hematol Blood Transfus

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“…· Our report demonstrates that nystatin A affects the synthesis of all viral proteins during the replication of HIV-1 in H9 cells. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Ci/mmol, was purchased from Du Pont-New England Nuclear (Boston, MA). Poly(rA) oligo (dT)12_,8 and poly(dA) oIigo(dT)12 | g primers were obtained from Phanmacia/P-L Bio¬ chemicals (Piscataway, NJ).…”

Section: Introductionmentioning

confidence: 99%

Inhibition of HIV-1 Replication in H9 Cells by Nystatin-A Compared with Other Antiviral Agents

Selvam¹,

Blay²,

Geyer³

et al. 1993

AIDS Research and Human Retroviruses

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Nystatin A was compared in vitro with amphotericin B, AZT, or foscarnet for their respective abilities to inhibit the replication of human immunodeficiency virus type 1 (HIV-1) in H9 cells. HIV-1-infected H9 cells were cultured for 7 days in the presence of each of these drugs, at various concentrations. Reverse transcriptase activity and p24 antigen production were quantitated. Untreated, HIV-1-infected H9 cells served as the control. Nystatin A inhibited viral replication most effectively at 10 micrograms/ml, a concentration that did not affect cell viability. Nystatin-A treatment inhibited RT activity by 85% and p24 production by 90%. These levels of inhibition were comparable to that mediated by amphotericin B, AZT, or foscarnet at 10, 25, and 50 micrograms/ml, respectively. Western blot analysis of the HIV-1-infected H9 cells treated with these drugs did not detect any expression of viral proteins. These findings were further corroborated by indirect immunofluorescence studies using monoclonal anti-gp120 FITC-conjugated antibodies and by polymerase chain reaction for proviral DNA analysis, using a 32P-labeled probe. These results suggest that Nystatin A merits attention as an antiviral drug for the treatment of HIV-1 infection. In vivo drug delivery by liposome encapsulation to overcome problems of bioavailability is currently under study.

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“…The studies of zidovudine in patients with advanced HIV infection (CD4 cell count <200/mm 3 ) have demonstrated prolonged survival, decreased severity and frequency of opportunistic infections, weight gain and improved performance status (Fischl et al 1987(Fischl et al , 1989Lemp et al 1990;Moore et al 1991). We do not attempt to fully review the literature on this topic but do identify major developments.…”

Section: Treatment Principles and Clinical Efficacymentioning

confidence: 98%

Zidovudine Toxicity

Rachlis

Fanning

1993

Drug Safety

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Zidovudine is a dideoxynucleoside analogue of thymidine. It acts by interfering with viral reverse transcriptase, thereby inhibiting human immunodeficiency virus (HIV) replication. Zidovudine has been shown in clinical trials to prolong survival of patients with acquired immune deficiency syndrome (AIDS) and advanced AIDS-related complex (ARC), and to delay progression to ARC or AIDS in patients with earlier disease. At the present time it is suggested that zidovudine be initiated when the CD4 lymphocyte count is less than 500 cells/mm3. Recent studies have suggested a delay in the development of AIDS in patients with CD4 counts over 500 cells/mm3, but ongoing studies will require confirmation. The adverse reactions associated with zidovudine have been well described. It appears that haematological toxicity is associated with both the dose and stage of disease. Anaemia may present more often within the first 3 months of therapy, whereas neutropenia can occur early or late. Mild headache and gastrointestinal intolerance may occur early and in some cases limit tolerance to the drug. A number of neurological adverse reactions have been reported rarely including seizures and dose-reduction encephalopathy. The most significant late adverse reaction is that of myopathy, which occurs in patients receiving zidovudine for more than 6 months. With careful monitoring, the adverse reactions of zidovudine are manageable and patient tolerance of the medication is acceptable.

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Long-term Safety and Efficacy of Zidovudine in Patients With Advanced Human Immunodeficiency Virus Disease

Cited by 36 publications

References 12 publications

High Incidence of Zidovudine Induced Anaemia in HIV Infected Patients in Southern Odisha

High Incidence of Zidovudine Induced Anaemia in HIV Infected Patients in Southern Odisha

Inhibition of HIV-1 Replication in H9 Cells by Nystatin-A Compared with Other Antiviral Agents

Zidovudine Toxicity

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