Exacerbation of dideoxycytidine-induced neuropathy with dideoxyinosine

Article Abstract:

Currently, zidovudine (ZDV or AZT) is the only drug available for the direct treatment of human immunodeficiency virus (HIV) infection, which causes AIDS. ZDV works by inhibiting viral replication. Two other drugs, dideoxycytidine (ddC) and dideoxyinosine (ddI), are now being tested for their safety and effectiveness in treating HIV infection. Both may cause side effects that involve the nervous system. It is not known if these two drugs, when given together, can interact and cause greater and more severe side effects than when given alone. A few AIDS patients are receiving ddC and ddI in clinical trials. This study examined the case of an AIDS patient who was enrolled in a study involving ZDV and ddC. He had no neurologic problems when the study began. He was given ZDV and ddC on alternate months. After four months of drug therapy he developed symptoms of mild neuropathy, similar to those associated with ddC. The ddC was discontinued, and the symptoms stabilized. He then began treatment with ddI and within one week, his symptoms worsened. The ddI was discontinued and his symptoms resolved within one month. The onset of severe symptoms after ddI treatment was unusual. These findings suggest that ddC and ddI may have a synergistic or additive effect relative to side effects and toxicity. Patients given these drugs in combination or close in time should be carefully monitored for side effects. Further research on this drug interaction is warranted. (Consumer Summary produced by Reliance Medical Information, Inc.)

AIDS (Disease), Didanosine, Zalcitabine

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A phase 1 study of ribavirin in human immunodeficiency virus-infected patients

Article Abstract:

Previous studies have indicated that patients with AIDS-related complex (ARC) do not show signs of clinical improvement when treated with ribavirin in doses of 600 to 800 milligrams (mg) per day for six months. Further, it was reported that ribavirin caused a mild and reversible anemia in these patients. Additional clinical trials with ribavirin were conducted to determine if a stronger dosing regime would be effective in treating patients with ARC. A total of 16 homosexual men infected with human immunodeficiency virus (HIV, which causes AIDS) were given ribavirin in daily doses of 1,200 or 1,600 mg for 12 weeks. The average age of the study group was 36 years. Blood samples were analyzed for HIV infection, beta-macroglobulin (a serum protein that is elevated during HIV infection), and T lymphocytes (cells that stimulate antibody production). Ribavirin did not reduce HIV infection in cultured blood cells. During ribavirin treatment, parameters of lymphocyte function (antigen-induced blastogenesis and interferon-gamma production) did not improve, and serum levels of beta-macroglobulin were not reduced. Ribavirin was toxic to lymphocytes, significantly reducing the number of T lymphocytes in the blood. Side effects of ribavirin treatment included headache, insomnia, agitation, dry skin, and anemia. These findings demonstrate that ribavirin has no therapeutic value in treating patients with HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

AIDS-related complex

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Clinical, virologic, and immunologic effects of combination therapy with ribavirin and isoprinosine in HIV-infected homosexual men

Article Abstract:

Ribavirin is a drug that is effective against various types of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) viruses, including the human immunodeficiency virus (HIV). Adverse effects of ribavirin include central nervous system side effects and anemia. Isoprinosine, a synthetic derivative of the naturally occurring substance inosine, has been shown to improve immune or natural defense system responses in HIV-infected patients. The effectiveness of a combined regimen of ribavirin and isoprinosine was assessed in 15 HIV-infected homosexual men for up to three months; the subjects had no symptoms of HIV infection. The men were divided into groups receiving 4 grams per day of isoprinosine combined with either 800 or 1,200 milligrams per day of ribavirin. Eight minor HIV-related incidents occurred in six patients during the study. The drug combination did not alter blood levels of p24 antigen, a component of the virus that can activate the immune system, nor did it improve suppressed immune responses. Treatment was associated with the development of lymphopenia, a deficiency of lymphocytes, which are immune cells. The results show that isoprinosine combined with ribavirin causes lymphopenia and does not suppress HIV activity or restore immune functions, which are weakened in HIV-infected patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Immunological deficiency syndromes, Immunologic deficiency syndromes, Antiviral agents, Isoprinosine

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