Efficacy and safety of zidovudine and zalcitabine combined with a combination of herbs in the treatment of HIV-infected Thai patients.

A randomized double blind placebo controlled trial to determine the efficacy and safety of combined-herbs (SH) given with zidovudine (ZDV) and zalcitabine (ddC) for the treatment of HIV infection in Thai adults was conducted in 3 hospitals in northern Thailand during 2002 to 2003. The eligible subjects were HIV-infected Thai adults who had never received anti-retrovirals, had a Karnofski Performance Score (KPS) of > or = 70, and had no opportunistic infections. The subjects were randomized to receive either a combination of ZDV 200 mg three times per day, ddC 0.75 mg three times per day, and SH 2.5 g three times per day or a combination of ZDV 200 mg three times per day, ddC 0.75 mg three times per day, and placebo 2.5 g three times per day for 24 weeks. The main outcome measures were HIV-RNA, CD4 cells, and blood chemistry profiles prior to the treatment and then every 4 weeks for 24 weeks. The baseline characteristics of 60 evaluable subjects, 40 in the SH group and 20 in the placebo group, were not significantly different. HIV RNA at week 4 and thereafter was significantly decreased from the baseline value in both groups (p<0.001). However, the decline in HIV RNA in the SH group was significantly more than that in the placebo group. The CD4 cells in the SH group at week 12 and thereafter were significantly increased from the baseline value. Serious adverse events in the two groups were not observed. It is concluded that an addition of SH herbs to two nucleoside reverse transcriptase inhibitors has greater antiviral activity than antiretrovirals only. The SH herbs may be an alternative for the third anti-retroviral agent in the triple drug regimen for the treatment of HIV infected patients in countries with limited resources.

Zalcitabina / Zalcitabine

Revisao sucinta quimioterapico antiviral,contendo:emprego clinico,mecanismo de acao,farmacocinetica,efeitos adversos,precaucoes,contra-indicacoes,interacoes medicamentosas,associacoes farmacologicas e posologia.

Didesoxicitidina y zidovudina secuenciales en infección avanzada por virus VIH-1: estudio fase II / Efficacy of sequential dideoxycytidine and zidovudine in stage IV HIV-1 infection: phase II study

Se estudiaron prospectivamente 17 pacientes infectados por VIH-1 tratados con ddC (0.375 mg tid durante 30 días), alternado con AZT (100 mg tid durante 30 días), por periodos de 8 a 32 semanas, medida de 17. Trece pacientes recibieron este tratamiento después de otros antirretrovirales, y cuatro lo recibieron desde el diagnóstico. Antes y después de AZT/ddC, la medida de células CD4 cambió de 184 a 164/uL (p NS), y la media de peso de 60 a 61 kg (p NS). Los parámetros hematológicos mejoraron en pacientes expuestos previamente a AZT. En uno de los cuatro casos desapareció la antigenemia P24 y en tres de nueve disminuyeron los niveles de beta-2-microglobulina sérica. En uno hubo neuropatía periférica sensorial reversible como efecto colateral de ddC y en ocho cedieron efectos adversos de AZT como intolerancia gástrica, cefalea y fiebre. La administración combinada secuencial de AZT/ddC fue bien tolerada y se disminuyó la toxicidad de AZT.