High levels of toxic effects associated with antiretroviral treatment for HIV have been recorded and quantified by a group of Swiss researchers in a study published this week in The Lancet. If efficacy levels of drug combinations are similar, treatment choice will depend on the toxic effects of the drugs. Therefore, the data may be useful as a reference for future analyses of adverse effects of different treatment regimens. //

Dr Jacques Fellay from the University Hospital of Lausanne, and colleagues from the Swiss HIV Cohort Study, identified 1,160 HIV-positive patients receiving antiretroviral treatment for their condition. The researchers found that 47 per cent of patients taking part in the study exhibited clinical and 27 per cent exhibited laboratory evidence of drug-related adverse effects. Analysis of symptoms revealed that 9 per cent of those with clinical adverse symptoms and 30 per cent of those with laboratory adverse symptoms were serious or severe.

Fatigue and headache were reported by 37 and 22 per cent of the patient population, respectively. The researchers identified specific associations between different compounds, including lipodystrophy and high creatine phosphokinase concentrations with stavudine, thrombocytopaenia with saquinavir, mood disorders with lamivudine and hyperlactataemia with didanosine and stavudine. However, the reported effects of a particular drug are associated with levels of its actual use, and this is likely to be reflected in the data collected, the researchers warn.


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