Stavudine-associated peripheral neuropathy in zidovudine-naïve patients: effect of stavudine exposure and antiretroviral experience.
A post hoc analysis of safety data from study protocol NZT40012 assessed the incidence of conditions defined by the Centers for Disease Control and Prevention in 86 zidovudine-naïve, antiretroviral-experienced patients with HIV-1 infection who responded poorly (plasma HIV-1 RNA > 1000 copies/mL) despite at least 4 months' treatment with stavudine-containing regimens. Peripheral neuropathy occurred in 21%; other conditions were seen less frequently (candidiasis [13%], herpes zoster [12%], diarrhea lasting > 1 month [9%], Pneumocystis carinii pneumonia [9%], and wasting syndrome [8%]). The incidence of peripheral neuropathy rose significantly with the number of drugs comprising treatment regimens (> or = 4 vs 1-3; P = .013) and tended to be higher in patients with longer exposure to stavudine (29% with > or = 24 months' exposure vs 13% with < 24 months). Because peripheral neuropathy was observed with such high frequency, vigilance for signs and symptoms of this condition appears warranted if stavudine-containing regimens are to be continued.
Scarsella
Anthony
A
Pacific Oaks Medical Center, Beverly Hills, California 90211, USA.
Coodley
Gregg
G
Shalit
Peter
P
Anderson
Roger
R
Fisher
Robin L
RL
Liao
Qiming
Q
Ross
Lisa L
LL
Hernandez
Jaime E
JE
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D018119:Stavudine / Q000009:adverse effects*; D015215:Zidovudine / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D015215:Zidovudine; D018119:Stavudine