Document 0622
 DOCN  M9610622
 TI    Risk factors for dideoxynucleoside-induced toxic neuropathy in patients
       with the human immunodeficiency virus infection.
 DT    9601
 AU    Fichtenbaum CJ; Clifford DB; Powderly WG; AIDS Clinical Trials Unit,
       Washington University School of; Medicine, St. Louis, Missouri 63108,
       USA.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Oct 1;10(2):169-74.
       Unique Identifier : AIDSLINE MED/96007279
 AB    Dideoxynucleosides induce a dose-related toxic neuropathy; however,
       there is a paucity of information on whether other risk factors
       influence the development of neuropathy. We reviewed the records of 103
       patients at an AIDS Clinical Trials Unit who were taking didanosine
       and/or zalcitabine to determine the risk factors for
       dideoxynucleoside-induced toxic neuropathy. Most were homosexual or
       bisexual (85%) men with a mean age of 39 years. The median CD4+
       lymphocyte count was 59 cells/mm3, and 35% had a previous diagnosis of
       AIDS. Toxic neuropathy was more common in patients taking zalcitabine
       compared with those taking didanosine (14 of 51 versus seven of 55, p =
       0.08). In the patients who took zalcitabine, those who had a low
       baseline serum cobalamin level, a history of heavy ethanol consumption,
       or a history of symptoms of peripheral nerve dysfunction were more
       likely to develop a toxic neuropathy (10 of 14 versus 12 of 37, p =
       0.01). Conversely, there were no factors associated with the development
       of didanosine-induced toxic neuropathy. Dideoxynucleoside-induced toxic
       neuropathy is a common problem that can be disabling but is usually
       reversible. A history of symptoms of peripheral nervous system disease,
       heavy ethanol consumption, or a low serum cobalamin level may be useful
       in distinguishing patients at higher risk of developing
       zalcitabine-induced toxic neuropathy.
 DE    Acquired Immunodeficiency Syndrome/*DRUG THERAPY/IMMUNOLOGY  Adult  Aged
       Antiviral Agents/*ADVERSE EFFECTS/THERAPEUTIC USE  CD4 Lymphocyte Count
       CD4-Positive T-Lymphocytes  Didanosine/*ADVERSE EFFECTS/THERAPEUTIC USE
       Drug Therapy, Combination  Female  Human  HIV Infections/*DRUG
       THERAPY/IMMUNOLOGY  Incidence  Male  Middle Age  Peripheral Nervous
       System Diseases/*CHEMICALLY INDUCED/IMMUNOLOGY  Retrospective Studies
       Risk Factors  Support, U.S. Gov't, P.H.S.  Zalcitabine/*ADVERSE
       EFFECTS/THERAPEUTIC USE  JOURNAL ARTICLE

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