Sahel Medical Journal

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Effects of stavudine - based antiretroviral therapy on distal symmetrical polyneuropathy in hiv/aids patients: a preliminary report

O.R Obiako, I Abdu-Aguye, A Ogunniyi


Background: Distal symmetrical polyneuropathy is a debilitating illness seen in more than 30% of antiretroviral naïve Acquired immune deficiency syndrome patients and 4% of those on stavudine
and didanosine, current first-line antiretroviral drugs in Nigeria. This study determines the influence of stavudine-based antiretroviral therapy on: Distal symmetrical polyneuropathy in Human immunodeficiency virus/acquired immune deficiency syndrome patients.
Methods: We carried out prospective cross-sectional study of 220 antiretroviral-naïve Human immunodeficiency virus/acquired immune deficiency syndrome adult patients referred to the antiretroviral human immuno deficiency virus care and treatment clinic in Ahmadu Bello University Teaching Hospital, Shika Zaria between August 2005 and May 2006 They were evaluated using a protocol modified from the subjective peripheral neuropathy screen and the Leeds assessment of
neuropathic symptoms and signs pain score. Each subject was then put on capsule stavudine 30/40 mg (based on body weight) twice daily + tablet lamivudine 150 mg twice daily + tablet nevirapine 200 mg (daily for 2 weeks and twice daily thereafter). After 3 months they were re-evaluated using same baseline protocol. Subjects with diabetes, renal or liver disease, prior ART-experience, and on antituberculous therapy were excluded from the study. Results: After 3 months of antiretroviral therapy the median symptoms and signs was significantly
reduced from 31.4% (range 3.2% to 42.3%) to 18.2% (range 0.5% to 25.5%) and 18.2% (range 0.5% to 84.1%) to 5.9% (range 0.0% to 83.6%), respectively. Conclusion: Significant reductions in the frequencies of DSP symptoms and signs were observed
with stavudine-based ART. Our findings as well as the long term neurotoxic effects of this relatively affordable regimen in a resource depleted setting needs to be confirmed in a larger scale and multicentered study.
AJOL African Journals Online