Re: Zidovudine and Anaemia: Important Observations

[Guest guest]

Dear FORUM,

Re: Dr Diwakar Tejaswi's observation on Zidovudine and Anemia,

Yes, I agree with those observations. In my cohort of 500 + patients of as

treated and +200 intent to treat patients also the number of patients suffering

from anemia due to Zidovudine, is statistically significant.

I feel in our scenario otherwise also anemia is common and it is not a bad idea

for Indians to still prefer d4T+3Tc+NVP combination. The comparison of two

regimens does not show much difference as far as success of clinical and

immunological and virological status is concerned.

Dr.Rakesh Bharti

BDC Research Center,

27-D,Sant Avenue,

The Mall, Amritsar,143001

e-mail: rakeshbharti1@...

[Guest guest]

Dear Forum,

This is in response to Dr Rakesh Bharati's response on ZDV induced

anemia:

d4T+3Tc+NV Pcombination causes significant number of life threatening

Lactic acidosis and irreversible periferal painful neuropath which is

not very easy to be detected in a peripheral clinic.

This also may lead to the discontinuation of ART which may further lead to

worsening of disease or development of resistance. At the same time ZDV can be

replaced by Stavudine/ ABV/Tenofovir in the event of ZDV induced anemia,

without interrupting the ART. As anemia is not a class specific toxicity.

Dr Ajithkumar.K

e-mail: <trc_ajisudha@...>

[Guest guest]

Dear FORUM,

Let me thank Dr. Ajithkumar.K for his response to my letter.

I lost one patient of d4T+3TC+NVP comibnation to lactic acidosis. Peripheral

neuropathy was tackled well with the use of modalities available including

Thalidomide and hardly any patient left treatment in between for this reason.

Inclusion of Tenofovir is a good idea but only deterrent is the cost.

D4T problem remains the same and Abacavir, i do not know i do not have much

experience.

Dr.Rakesh Bharti,

BDC Research Center,

27-D,Sant Avenue,

The Mall,

Amritsar,143001

tel-09814044213

email-rakesh.bharti1@...