Zidovudine and Anaemia: Imp Observations

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Dear Forum Members, I wish to take this opportunity to share with you my preliminary alarming finding with regard to ART. At present i am treating about 65 full blown AIDS cases. As per the protocol after CD4 and clinical assessment i was putting the patients on 2 NRTI ( Mainly Zidovudine and Lamivudine) + 1 NNRTI ( Nevirapine if pt. is not on DOTS). But now i have analysed the 6 month old cohort and found that the occurance of marked anaemia ( in 8 patients Hb decreased to less than 40%, who had Hb > 85% at the start of treatment ). I had to change them to Stavudine + Lamivudine combination among NRTI's.. May be we ( Indian Population) don't have enough reserve of Iron or there is some spl. genetic makeup that leads to faster depletion of Hb with Zidovudine or other hypothesis can be generated and tested. This is to kindly request the treating physicians to share their experiences with Zidovudine

and anaemia. The other observation that i like to share with forum members is that the classical efficiency of transmission through heterosexual route ( 0.1% to 1%) is sometimes not fitting in my practical observation. i have 5 patients ( out of 65 pts) who got the infection in just 2-3 exposures. May be our natural immunity against virus is less compared to western world from where we got the classical transmission efficiency staistics or may be our population has more latent or active STDs that leads to increased efficiency of transmission. Dr Diwakar Tejaswi General Physician and Medical Director Regional AIDS Training Center and Network in India ( RATNEI) International Health Organization 1, Harinaryan Complex Exhibition Road, Patna 800001 India Ph: 09835078298 email: diwakartejaswi@...

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