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TDF+3TC+d4T
Is Significantly Better Tolerated Than ZDV+3TC or ZDV+3TC+NFV as
Non-occupational HIV Post-exposure Prophylaxis and Results in Improved
Adherence
Non-occupational
post-exposure prophylaxis (NPEP) for HIV is recommended after high-risk
sexual exposure. Because of the high incidence of intolerable side effects
observed with protease
inhibitor- and zidovudine
(Retrovir)-based NPEP regimens, researchers at St Vincent’s Hospital
in Sydney, Australia changed standard NPEP treatment to 28 days
of tenofovir (Viread)-lamivudine (Epivir)-stavudine (Zerit)/
TDF-3TC-d4T.
The
aim of this study was to compare side effects and numbers of individuals
completing NPEP before and after this change.
Parameters
were compared among individuals commencing the following NPEP regimens:
zidovudine-lamivudine/ ZDV-3TC, zidovudine-lamivudine-nelfinavir
(Viracept)/ ZDV-3TC-NFV and TDF-3TC-d4T.
Results
·
A
total of 385 individuals received ZDV-3TC (n=36), ZDV-3TC-NFV (n=225)
or TDF-3TC-d4T (n=137) as NPEP for the first time between June 1999
and November 2003.
·
Non-completion
rates were 25%, 32% and 15%, respectively (P=0.001).
·
Adverse
events were less common in the TDF-3TC-d4T group, with significantly
lower rates of nausea and headache, but significantly higher rates
of peripheral
neuropathy and asymptomatic raised
transaminases.
·
There
was no HIV seroconversion in any group.
Based
on these findings, the authors conclude, “TDF-3TC-d4T is significantly
better tolerated than ZDV-3TC or ZDV-3TC-NFV as NPEP and results
in greater numbers of individuals completing 28 days of treatment.”
Department of Immunology,
HIV and Infectious Diseases, St Vincent's Hospital, Sydney, Australia.
05/27/05
Reference
A
Winston and others. The use of a triple nucleoside-nucleotide regimen
for nonoccupational HIV post-exposure prophylaxis. HIV
Medicine 6(3):191-197. May 2005.
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