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Electrophysiological examinations of the peripheral nerve in HIV-1-infected individuals under stavudine therapy.


Int Conf AIDS. 1998;12:1006 (abstract no. 60023). Unique Identifier :

OBJECTIVES: To find out about the potential neurotoxic effect of stavudine: (2O,3O-Didehydro-3O-deoxythymidine; D4T) on the peripheral nervous system under the conditions of careful pre-treatment screening of HIV-1-seropositive patients before new onset of stavudine treatment. DESIGN: Retrospective analysis of all electroneurographic examinations performed in patients under treatment with stavudine. METHODS: Before starting therapy, all HIV-1-seropositive patients were neurologically examined in our center. Stavudine was not given if any risk factor for polyneuropathy (i.e. diabetes mellitus, family history, vitamin B 12 deficiency or prior treatment with neurotoxic drugs) was present. Mean dosage of stavudine was 1.0 mg/kg/day. 180 patients were newly started. In 107, nerve conduction velocity studies were available (group 1). Electrophysiological results (motor and sensory), conduction velocities, motor and sensory nerve action potentials, both upper and lower extremities) were compared to 103 HIV-1-seropositive controls (group 2) who received a comparable treatment with zidovudine instead of stavudine. Group 1 consisted of 59 patients with stavudine, lamivudine and a protease inhibitor, 22 patients with stavudine and lamivudine, 11 patients with stavudine and didanosine and 15 patients with stavudine monotherapy. Group 2 consisted of 29 patients with zidovudine, lamivudine and a protease inhibitor, 29 patients with zidovudine and lamivudine and 45 patients with zidovudine and didanosine. RESULTS: Comparing groups 1 and 2 with a Mann-Whitney-U test and comparing the different treatment subgroups by a Kruskal-Wallis test revealed no significant differences between patients under stavudine and those without. CONCLUSIONS: Careful clinical neurological screening of HIV-1-seropositive patients before starting stavudine treatment may prevent to a large extent stavudine-related toxic neuropathy.

MEETING ABSTRACTS Action Potentials/DRUG EFFECTS Anti-HIV Agents/*ADVERSE EFFECTS/THERAPEUTIC USE Drug Therapy, Combination Human HIV Seropositivity/*DRUG THERAPY HIV-1/*DRUG EFFECTS Motor Neurons/DRUG EFFECTS Peripheral Nerves/*DRUG EFFECTS Reaction Time/DRUG EFFECTS Receptors, Sensory/DRUG EFFECTS Risk Factors Stavudine/*ADVERSE EFFECTS/THERAPEUTIC USE Synaptic Transmission/*DRUG EFFECTS


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