Side Effects of zidovudine: A Synthesis of Findings from 27 Studies

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Original Abstract of the Article

Main Research Findings

Zidovudine is a widely used antiretroviral drug for HIV treatment, but it can cause a range of side effects. Studies have shown that zidovudine can lead to anemia, headache, fatigue, nausea, and bone marrow suppression. In addition, zidovudine can affect mitochondrial DNA polymerase, potentially causing mitochondrial dysfunction. 20 It's also crucial to note that zidovudine is used to prevent HIV transmission from pregnant mothers to their children, and it can cause side effects in pregnant women and children. 13

Reasons for Side Effects

Zidovudine works by inhibiting an enzyme called reverse transcriptase, which is essential for HIV to replicate. This enzyme converts HIV's RNA into DNA, a step vital for the virus's lifecycle. Zidovudine binds to reverse transcriptase and prevents it from functioning properly. However, zidovudine can also interfere with other enzymes within cells, leading to side effects.

Common Side Effects

Anemia

Zidovudine can cause anemia by inhibiting red blood cell production.

Headache

Zidovudine can cause headaches.

Fatigue

Zidovudine can cause fatigue.

Nausea

Zidovudine can cause nausea.

Skin Rash

Zidovudine can cause skin rashes, sometimes severe. 8

Bone Marrow Suppression

Zidovudine can suppress bone marrow function, leading to a decrease in white blood cells and platelets.

Mitochondrial Dysfunction

Zidovudine can affect mitochondrial DNA polymerase, potentially causing mitochondrial dysfunction. 20

Diabetes

Zidovudine may worsen existing diabetes. 3

Countermeasures for Side Effects

Anemia

If you experience symptoms of anemia, your doctor may recommend iron supplements or other treatments.

Headache

If you experience headaches, consult with your doctor.

Fatigue

If you experience fatigue, try to get enough rest and talk to your doctor.

Nausea

If you experience nausea, eat small meals several times a day and discuss strategies with your doctor.

Skin Rash

If you develop a skin rash, consult your doctor immediately.

Bone Marrow Suppression

If you experience symptoms of bone marrow suppression, your doctor may monitor your blood counts and adjust treatment accordingly.

Mitochondrial Dysfunction

If you experience symptoms that might indicate mitochondrial dysfunction, consult with your doctor for diagnosis and potential management.

Diabetes

If you have diabetes, carefully monitor your blood sugar levels and discuss your treatment with your doctor.

Comparison Between Studies

Commonalities in Studies

Several studies have documented side effects associated with zidovudine. Commonly reported side effects include anemia, headache, fatigue, and nausea. There is also evidence that zidovudine can cause side effects in pregnant women and children. 13

Differences Between Studies

The specific types and severity of side effects can vary depending on the study. Additionally, research on the effects of zidovudine on mitochondria has yielded different results. 20

Precautions for Real-Life Applications

It is important to remember that while zidovudine is a vital medication for HIV treatment, it does come with potential side effects. Before starting zidovudine, discuss these risks with your doctor. If you experience any side effects, consult with your doctor right away.

Limitations of Current Research

Research on zidovudine continues to evolve, and there are still gaps in our understanding. More research is needed to investigate the long-term effects of zidovudine on mitochondria.

Future Research Directions

Future research efforts should focus on developing new treatments and preventive measures to minimize zidovudine side effects. It's also critical to conduct further research on the long-term impacts of zidovudine on mitochondria.

Conclusion

Zidovudine is a crucial medication in HIV treatment, but it's important to be aware of the associated side effects. Before starting zidovudine, discuss the potential risks with your doctor, and report any side effects immediately. Continued research is necessary to better understand and mitigate the side effects of this important drug.

Literature analysis of 27 papers
Positive Content
22
Neutral Content
3
Negative Content
2
Article Type
2
0
1
2
27
1.

Nature, time course and dose dependence of zidovudine-related side effects: results from the Multicenter Canadian Azidothymidine Trial.

Author: GelmonK, MontanerJ S, FanningM, SmithJ R, FalutzJ, TsoukasC, GillJ, WellsG, O'ShaughnessyM, WainbergM

Bone marrow changes
Hemoglobin decrease
Zidovudine side effects

Zidovudine treatment resulted in dose-dependent side effects, including nausea, fatigue, and headache, with a decrease in hemoglobin and bone marrow changes.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Targeting EPO and EPO receptor pathways in anemia and dysregulated erythropoiesis.

Author: RainvilleNicole, JachimowiczEdward, WojchowskiDon M

Anemia treatment
Cancer progression
Costly
Hypertension

Recombinant human erythropoietin (rhEPO) is a first-line therapeutic for the anemia of chronic kidney disease, cancer chemotherapy, AIDS (Zidovudine therapy), and lower-risk myelodysplastic syndrome. However, rhEPO frequently elevates hypertension, is costly, and may affect cancer progression. Potentially high merit therefore exists for defining new targets for anti-anemia agents within erythropoietin (EPO) and EPO receptor (EPOR) regulatory circuits.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Switch to rilpivirine improves diabetes in an elderly HIV-positive patient.

Author: UcciferriClaudio, Di RosaZaira, VignaleFrancesca, VecchietJacopo, FalascaKatia

Diabetes treatment
HIV infection treatment
Diabetes
Glucose intolerance

This case report highlights the development of unbalanced diabetes in a 72-year-old man with long-term HIV infection treated with zidovudine. Switching to rilpivirine significantly improved diabetes control, suggesting that rilpivirine might be a better option for patients with HIV infection who experience glucose metabolism issues associated with zidovudine.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Design and pharmaceutical evaluation of a nano-enabled crosslinked multipolymeric scaffold for prolonged intracranial release of Zidovudine.

Author: HarilallSheri-lee, ChoonaraYahya E, ModiGirish, TomarLomas K, TyagiCharu, KumarPradeep, du ToitLisa C, IyukeSunny E, DanckwertsMichael P, PillayViness

Reduced side effects
Sustained drug release

This study explores the use of nanomedicine to develop an implantable drug delivery device capable of sustained zidovudine release. The aim is to create a device that provides controlled drug delivery over a prolonged period, reducing side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Safety of 6-week Neonatal Triple-combination Antiretroviral Postexposure Prophylaxis in High-risk HIV-exposed Infants.

Author: AnugulruengkittSuvaporn, SuntarattiwongPiyarat, OunchanumPradthana, SrirompotongUssanee, JantarabenjakulWatsamon, SophonphanJiratchaya, PunnahitanonSunti, PancharoenChitsanu, CresseyTim R, ChokephaibulkitKulkanya, PuthanakitThanyawee,

Prevent HIV transmission
Adverse events

Zidovudine/lamivudine/nevirapine is safe for neonatal postexposure prophylaxis (PEP) for HIV-exposed infants.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Use of nucleoside reverse transcriptase inhibitor-only regimens in HIV-infected children and adolescents.

Author: NeelyMichael, RutsteinRichard, Del BiancoGabriela, HeresiGloria, BartonTheresa, WizniaAndrew, WiegandRyan, WheelingTravis, BohannonBeverly, DominguezKenneth,

HIV-1 treatment

This study examines the virological, immunological, and toxicological effects of nucleoside reverse transcriptase inhibitor-only antiretroviral regimens (NOARs) in children and adolescents. The findings aim to better understand the efficacy and safety of NOARs in this population.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

7.

Lamivudine-Induced Skin Rash Remains an Underdiagnosed Entity in HIV: A Case Series from a Single Center.

Author: SachdevaRavinder Kaur, SharmaAman, DeDipankar, MalhiJasjit, RewariBharat Bhushan, SinghSurjit, VarmaSubhash

Rash treatment
Lamivudine rash

Lamivudine-induced rash was found at a frequency of 0.7% in HIV-infected individuals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

8.

Severe skin rash with lamivudine in HIV infected patients: some unusual case reports.

Author: ModakDolanchampa, GuhaSubhasish Kamal

HIV treatment
Skin rash

This study reported a case series of severe skin rashes in four HIV-infected patients likely caused by lamivudine, a nucleoside reverse transcriptase inhibitor used in HIV and hepatitis B treatment.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

The financial and service implications of splitting fixed-dose antiretroviral drugs - a case study.

Author: TaylorR, CarlinE, SadiqueZ, AhmedI, AdamsE J

HIV treatment
Increased costs
Patient confusion

This study assessed the true costs and patient outcomes associated with switching from the fixed-dose combination Combivir to component drugs. Switching resulted in higher costs and some patients reported problems with the switch.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Trends in first-line antiretroviral therapy in Asia: results from the TREAT Asia HIV observational database.

Author: BoettigerDavid Charles, KerrStephen, DitangcoRossana, MeratiTuti Parwati, PhamThuy Thi Thanh, ChaiwarithRomanee, KiertiburanakulSasisopin, LiChung Ki Patrick, KumarasamyNagalingeswaran, VonthanakSaphonn, LeeChristopher, Van KinhNguyen, PujariSanjay, WongWing Wai, KamarulzamanAdeeba, ZhangFujie, YunihastutiEvy, ChoiJun Yong, OkaShinichi, NgOon Tek, KantipongPacharee, MustafaMahiran, RatanasuwanWinai, SohnAnnette, LawMatthew

Adverse event rate decreased
Treatment failure reduced
Adverse events
Stavudine use

Trends in first-line antiretroviral therapy use in Asia reflect changes in drug availability and global treatment recommendations. These changes have contributed to a decline in treatment modification due to adverse events but not to reductions in treatment failure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Adherence to zidovudine for the prevention of perinatal transmission in HIV-infected pregnant women: the impact of social network factors, side effects, and perceived treatment efficacy.

Author: DemasPenelope A, TheaDonald M, WeedonJeremy, McWayneJanis, BamjiMahrukh, LambertGenevieve, SchoenbaumEllie E

HIV Prophylaxis

Social support groups and disclosure to the participant's mother were associated with better adherence to zidovudine prophylaxis among pregnant HIV-infected women.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

14.

Long-term combined rIFN-alpha-2a and zidovudine therapy for HIV-associated Kaposi's sarcoma: clinical consequences and side effects.

Author: StadlerR, BratzkeB, SchaartF, OrfanosC E

HIV-associated KS treatment
Improved immune system
HIV-cachexia
Intolerance
Opportunistic infections

Combination therapy of interferon alpha (IFN-alpha) and zidovudine (AZT) was found to be effective in controlling HIV-related Kaposi's sarcoma in more than 40% of patients. In a study of 21 homosexual men with histologically proven HIV-associated KS, complete remission was observed in 4 patients, partial remission in 3, stable disease in 2, and progression in 6. Negative p24 expression prior to treatment was a positive predictor of response.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Clinical and histopathological aspects of lichenoid dermatitis in patients of retroviral diseases.

Author: TambeSwagata A, ZambareUddhao S, NayakChitra S, PatilPriyanka D, ChhonkarAditi

LP treatment
LP

Lichen planus (LP) is rarely reported in HIV patients, but our case series of 20 patients highlights the possible etiology and challenges in managing LP-like lesions in this population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Tenofovir disoproxil fumarate safety for women and their infants during pregnancy and breastfeeding.

Author: MofensonLynne M, BaggaleyRachel C, MameletzisIoannis

Lactation safety
Pregnancy safety
HIV acquisition
Maternal bone density
Neonatal mortality
Preterm delivery

There does not appear to be a safety-related rationale for prohibiting preexposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) during pregnancy/lactation or for discontinuing PrEP in HIV-uninfected women who become pregnant.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Gelatin modified lipid nanoparticles for anti- viral drug delivery.

Author: K SJoshy, SSnigdha, KalarikkalNandakumar, PothenLaly A, ThomasSabu

Enhanced cellular uptake
Sustained release

Zidovudine-loaded polymer modified lipid nanoparticles were developed as a potential carrier for safe and efficient HIV/AIDS therapy. The nanoparticles exhibited sustained release of zidovudine, enhanced cellular internalization in both MCF-7 and neuro 2a brain cells, and low cytotoxicity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Highly active antiretroviral therapy and dyslipidemia in people living with HIV/AIDS in Fako Division, South West Region of Cameroon.

Author: NsaghaDickson Shey, WeledjiElroy Patrick, AssobNguedia Jules Clement, NjundaLongdoh Anna, TanueElvis Asangbeng, KibuOdette Dzemo, AyimaCharlotte Wenze, NgoweMarcelin Ngowe

Reduced HIV/AIDS morbidity
Reduced HIV/AIDS mortality
Cardiovascular disease
Dyslipidemia

The study aimed to determine the prevalence of dyslipidemia and its factors in people living with HIV/AIDS in Cameroon who use HAART regimens.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

Caenorhabditis elegans as a Model System for Studying Drug Induced Mitochondrial Toxicity.

Author: de BoerRichard, SmithRuben L, De VosWinnok H, MandersErik M M, BrulStanley, van der SpekHans

Treats HIV-1 infection
Mitochondrial toxicity

This study uses Caenorhabditis elegans to investigate the mitochondrial toxicity of antiretroviral drugs. The study shows that different antiretroviral drugs with similar mechanisms can have distinct effects on mitochondria and that mitochondrial toxicity is not solely caused by interference with the mitochondrial DNA polymerase.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Emulating a target trial of antiretroviral therapy regimens started before conception and risk of adverse birth outcomes.

Author: CanigliaEllen C, ZashRebecca, JacobsonDenise L, DisekoModiegi, MayondiGloria, LockmanShahin, ChenJennifer Y, MmalaneMompati, MakhemaJoseph, HernánMiguel A, ShapiroRoger L

TDF/FTC/EFV
Adverse birth outcomes

Preconception initiation of zidovudine, lamivudine, nevirapine (ZDV/3TC/NVP) compared with tenofovir, emtricitabine, efavirenz (TDF/FTC/EFV) may increase the risk of adverse birth outcomes. A retrospective study found that women initiating ZDV/3TC/NVP had a higher risk of stillbirth, preterm delivery, very preterm delivery, small-for-gestational-age, very small-for-gestational-age, and any severe birth outcome. These findings suggest that TDF/FTC/EFV may be a safer option for preconception ART initiation.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Increases in regimen durability associated with the introduction of tenofovir at a large public-sector clinic in Johannesburg, South Africa.

Author: BrennanAlana T, MaskewMhairi, IvePrudence, ShearerKate, LongLawrence, SanneIan, FoxMatthew P

HIV treatment durability

Tenofovir replaced stavudine in South Africa's public-sector first-line antiretroviral therapy (ART) in April 2010. Tenofovir is associated with fewer side effects and toxicities than stavudine, potentially leading to longer-lasting tenofovir-based treatment regimens. The study evaluated changes in regimen durability at the Themba Lethu Clinic in Johannesburg, South Africa.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

25.

Efficacy and safety of maraviroc vs. efavirenz in treatment-naive patients with HIV-1: 5-year findings.

Author: CooperDavid A, HeeraJayvant, IvePrudence, BotesMariette, DejesusEdwin, BurnsideRobert, ClumeckNathan, WalmsleySharon, LazzarinAdriano, MukwayaGeoffrey, SaagMichael, van Der RystElna

Improved CD4 count
Long-term antiviral efficacy
No long-term safety concerns
Well tolerated
Treatment-related AEs

Maraviroc maintained similar long-term antiviral efficacy to efavirenz over 5 years in treatment-naive patients with CCR5-tropic HIV-1. Maraviroc was generally well tolerated with no unexpected safety findings or evidence of long-term safety concerns.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

Long-term clinical remission maintained after cessation of zidovudine and interferon-α therapy in chronic adult T-cell leukemia/lymphoma.

Author: CookLucy B, RowanAileen G, DemontisMaria A, SagaweSophie, GilletNicolas A, MelamedAnat, GreillerClaire, WitkoverAviva, BanghamCharles R M, TaylorGraham P

Improved survival
Long-term remission
Disease relapse

This study reports a case of a patient with adult T-cell leukemia/lymphoma (ATL) who achieved long-term remission after treatment with zidovudine and interferon-α. This provides evidence that long-term remission may be possible in some patients with ATL, even after stopping therapy.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

27.

Risk factors for mortality in a south Indian population on generic antiretroviral therapy.

Author: RupaliPriscilla, MannamSam, BellaAnnie, JohnLydia, RajkumarS, ClarencePeace, PulimoodSusanne A, SamuelPrasanna, KarthikRajiv, AbrahamOoriapadickal Cherian, MathaiDilip

ART for HIV-infected adults
Mortality from ART

This study determined the risk factors for mortality among HIV-infected adults following the initiation of ART from a single center in south India, where ART programs have reported high mortality rates.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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