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When used with AZT, ddI and perhaps ddC, can delay HIV disease progression and death

Zidovudine (AZT) was the first antiretroviral drug used in HIV and AIDS. It is expensive and has several adverse effects including nausea, vomiting, blood problems (anaemia and neutropenia) and myopathy (muscle weakness). The next two drugs developed for HIV were didanosine (ddI) and zalcitabine (ddC). The adverse effects of ddI include nausea, vomiting, diarrhoea and problems with the pancreas (pancreatitis) and nerves in the arms and legs (peripheral neuropathy). Adverse effects of ddC are mouth ulcers and peripheral neuropathy. The review of trials found that both HIV disease progression and death are delayed by ddI, and perhaps also by ddC, at least when used with AZT.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Reducing the number of drugs in combination antiretroviral therapy for HIV after initial virologic response reduces the effectiveness of the treatment

Combination antiretroviral therapy can lower the amount of HIV in the blood, improve immune system function, and slow the progress of HIV. It is thought these drugs will need to be used for life. Keeping up this therapy, though, is difficult, and there are concerns about the adverse effects of the drugs and the development of resistance to the drugs over time. Therefore, attempting to use fewer drugs has been tried. However, the review of trials comparing combinations of three or four drugs, in patients who successfully completed initial therapy, with using fewer drugs found that a reduced number of drugs could not suppress the virus as well.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Screening for HIV: Systematic Review to Update the U.S. Preventive Services Task Force Recommendation [Internet]

A 2005 U.S. Preventive Services Task Force (USPSTF) review found good evidence that HIV screening tests are accurate and that identification of undiagnosed HIV infection and treatment of immunologically advanced disease is associated with substantial clinical benefits. However, it found insufficient evidence to estimate effects of diagnosis and subsequent interventions on transmission risks, or to estimate clinical benefits of antiretroviral treatment in patients with less immunologically advanced disease.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: November 2012
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Drug Class Review: Neuropathic Pain: Final Update 1 Report [Internet]

We compared the effectiveness and harms of anticonvulsants, tricyclic antidepressants, serotonin–norepinephrine reuptake inhibitors (SNRIs), and the lidocaine patchin adults with neuropathic pain.

Drug Class Reviews - Oregon Health & Science University.

Version: June 2011
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Initial highly-active antiretroviral therapy with a protease inhibitor versus a non-nucleoside reverse transcriptase inhibitor: discrepancies between direct and indirect meta-analyses

This review evaluated the effectiveness of initial highly-active antiretroviral therapy (HAART) with a protease inhibitor (PI) and a non-nucleoside reverse transcriptase inhibitor (non-NRTI). The authors concluded that non-NRTI-based HAART is more effective than PI-based HAART for virological suppression, but the interventions are similar for clinical outcomes. Despite some possible limitations, the conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Emergence of drug resistance in HIV type 1-infected patients after receipt of first-line highly active antiretroviral therapy: a systematic review of clinical trials

This review compared drug resistance profiles of patients with HIV type 1 infection after treatment with first-line antiretroviral therapy. The authors concluded that initial treatment with a boosted protease inhibitor-based regimen was associated with less resistance within and across drug classes. The reliability of this conclusion is unclear due to potential methodological weaknesses and gaps in the reporting process.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

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