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AIDS activists and researchers are at loggerheads over the planned SA trial of a lower-dose version of the controversial antiretroviral drug Stavudine.
The drug has in the past been responsible for debilitating side-effects in HIV patients.
The main adverse effect is peripheral neuropathy, which can be corrected by reducing dosage.
The symptoms of peripheral neuropathy include burning, stiffness, prickling, tingling, and numbness or a loss of feeling in the toes and soles of the feet.
Stavudine is also one of the most likely ARVs to cause lipodystrophy, and for this reason it is no longer considered an appropriate treatment for most patients in developed countries. However, due to its low price, it is widely used in developing countries.
Lipodystrophy is the redistribution of fat in the body, which manifests as excess, or lack of, fat in various parts of the body.
In one camp, the Treatment Action Campaign, Médecins Sans Frontières (Doctors Without Borders) and the Treatment Action Group have serious concerns about the proposed trial.
They are concerned that stavudine is more toxic than tenofovir (the drug that replaced stavudine in the government-treatment programme).
Patients’ poor tolerance means they are more likely not to adhere to treatment and will have to be switched to more expensive second-line treatment when they fail first-line treatment.
Those supporting the stavudine trial claim that tenofovir is unaffordable to most African countries.
The stavudine research team, led by the Wits Reproductive Health and HIV Institute’s Professor Francois Venter, said the evidence that stavudine produced bad side-effects was at the 40mg dose, but that it had been as effective as tenofovir at suppressing HIV at half this dose.
Activists have launched a petition against the study. – Health-e News