The use and toxicity of didanosine (ddI) in HIV antibody-positive individuals intolerant to zidovudine (AZT)
One hundred and fifty-one patients intolerant to zidovudine (AZT) received didanosine (ddI) to a maximum dose of 12.5 mg/kg/day. Patient response was assessed using changes in CD4+ lymphocyte subset count, HIV p24 antigen, weight, and quality of life. Seventy patients developed major opportunistic infections whilst on therapy; this was the first AIDS diagnosis in 17. Only minor changes in CD4+ lymphocyte subset count were observed in AIDS patients, although a more significant rise occurred in those with earlier stages of disease. Of those positive for p24 antigen at the commencement of the study 67% showed a positive response, and this was most likely in those with CD4+ lymphocyte subset counts above 100 mm3. A positive weight response was seen in 16% of patients. Most patients showed improvement in individual parameters and global score of quality of life. Adverse reactions possibly attributable to didanosine were common. The most common side-effect was diarrhoea, which resulted in cessation of therapy in 19 individuals. Peripheral neuropathy occurred in 12 patients and pancreatitis in six. Thirteen patients developed a raised serum amylase without abdominal pain. Seven patients developed glucose tolerance curves characteristic of diabetes but these were mild, did not require treatment and returned to normal on ceasing didanosine.
HIV/GUM Unit, Kobler Centre, Chelsea & Westminster Hospital, London.
G J
GJ
Moyle
M R
MR
Nelson
D
D
Hawkins
B G
BG
Gazzard
D000386:AIDS-Related Complex / Q000188:drug therapy* / Q000401:mortality; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000368:Aged; D001835:Body Weight; D003967:Diarrhea / Q000139:chemically induced; D016049:Didanosine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D016655:HIV Core Protein p24 / Q000187:drug effects; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D016131:Lymphocyte Subsets / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D011788:Quality of Life; D012307:Risk Factors; D015215:Zidovudine / Q000009:adverse effects*
D016655:HIV Core Protein p24; D015215:Zidovudine; D016049:Didanosine