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1996-01-30
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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
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).