title: 2',3'-didehydro-3'-deoxythymidine (d4T) in patients with AIDS or AIDS-related complex: a phase I trial.
abstract: 2',3'-didehydro-3'-deoxythymidine (d4T) is a pyrimidine analogue and inhibitor of reverse transcriptase with potent in vitro activity against human immunodeficiency virus (HIV). A phase I trial of d4T was conducted in 41 HIV-infected patients, 12 with AIDS and 29 with AIDS-related complex (ARC). Thirty-six patients were evaluatable. The maximum tolerated dose was 2 mg/kg/day. The dose-limiting toxicity was sensory peripheral neuropathy, which occurred in 20 patients (55%). Four patients (11%) developed hepatotoxicity. Five (14%) developed anemia requiring a transfusion but not discontinuation of drug. The mean +/- SE plasma elimination half-life at all dose levels was 1.2 +/- 0.09 h. Increased or stable absolute CD4 counts were seen in most patients. The majority of patients with detectable serum p24 antigen levels had a persistent decrease by 6 months. d4T is a promising drug for patients with AIDS or ARC. This clinical trial is continuing to determine the minimal effective dose.
authors.affiliation: Brown University AIDS Program, Providence, RI.
authors.forename: M J
authors.initials: MJ
authors.lastname: Browne
authors.forename: K H
authors.initials: KH
authors.lastname: Mayer
authors.forename: S B
authors.initials: SB
authors.lastname: Chafee
authors.forename: M N
authors.initials: MN
authors.lastname: Dudley
authors.forename: M R
authors.initials: MR
authors.lastname: Posner
authors.forename: S M
authors.initials: SM
authors.lastname: Steinberg
authors.forename: K K
authors.initials: KK
authors.lastname: Graham
authors.forename: S M
authors.initials: SM
authors.lastname: Geletko
authors.forename: S H
authors.initials: SH
authors.lastname: Zinner
authors.forename: S L
authors.initials: SL
authors.lastname: Denman
mesh_terms: D000386:AIDS-Related Complex / Q000188:drug therapy*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D016655:HIV Core Protein p24 / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D018119:Stavudine
chemical_list: D000998:Antiviral Agents; D015224:Dideoxynucleosides; D016655:HIV Core Protein p24; D018119:Stavudine