Initiating HIV/AIDS Therapy in Treatment-Naïve Patients Are Thymidine analogs still relevant today?
	Enlarged Version of Graphics Below	Dr. Kwakwa (OC): I absolutely think that thymidine analogues do, specifically zidovudine, although stavudine has fallen into a position of disfavor because of the multiple toxicities associated with it, and although there is a concern of some of those potential toxicities occurring over the longer term with zidovudine use, and clinical practice, that sort of has not been the experience, and people have been on zidovudine for more than 10 years, and have done quite well on it. The importance of zidovudine, or one of the issues that makes it particularly important, is because of its resistance-modulating effect, its additional barrier to resistance that it may provide to a regimen that may not, on its own, have an anchor drug, that it may not, in itself, have a very high barrier to resistance. Dr. Kwakwa (VO): So for example, in our practice, you find us using zidovudine-containing regimens when we are using non-nucleosides, when we are using-in the rare cases that we use unboosted protease inhibitors, for example, when we use regimens that have been shown to have high barriers to resistance, we are more likely to go to zidovudine-containing regimens. Also, certainly for anybody who for whatever reason goes on a triple nucleoside therapy, zidovudine is an important component of any triple nucleoside. The only one that is really recommended as an alternative by the DHHS guidelines, certainly, is Trizivir, which also contains zidovudine.   See Slide Dr. Wohlfeiler (OC): I do think that they're relevant. I think that they're a double-edged sword because we know that there are certain toxicities that may be more associated with thymidine analogs. But I do think that there is enough evidence out there to indicate that thymidines might help protect against certain mutations developing. And I think that there is intriguing evidence that the presence of a thymidine analog may reduce the risk of a K65R developing in patients who are on a tenofovir-based regimen. So though I don't think it's an absolute requirement to have a thymidine on board, I still think that there can be benefit to thymidines.
Program Menu	Last   |	Next