Politics Ignore Side Effects Of Stavudine

Today's post comes from journaids.org (see link below) and the South African newspaper the Mail and Guardian and talks about decisions being made to buy in the antiretroviral drug stavudine (d4T often called Zerit)). It is claimed that low doses of stavudine are just as effective as tenofovir (one of the bases of Truvada) in suppressing the HIV virus. Stavudine is much much cheaper than tenofovir and therefore seems to make sense if the comparison is true, especially in poorer countries in the third world. However the side effects of stavudine are well-documented and neuropathy caused by stavudine makes hundreds of thousands of people's lives a misery. At the end of the short intro is a link to the full article which is shown as a page of the newspaper - makes interesting reading.

Drug row sparked by HIV spending
Mara Kardas Nelson: Mail and Guardian: 12 July 2013

A new study to be conducted in South Africa, Uganda and India has sparked a heated debate in the HIV activist and research community, demonstrating a divide in strategy at the start of the fourth decade of the epidemic.

The debate has sprung from a clinical trial that aims to see whether low-dose stavudine, or d4T, is as effective as tenofovir, or TDF, one of the antiretrovirals (ARVs) currently recommended for first-line HIV treatment by the World Health Organisation (WHO). d4T was long used as the primary first-line therapy but harsh side effects, including neuropathy (nerve damage) and lipodystrophy (abnormal, sometimes disfiguring, fat distribution), led the WHO to recommend against its use in 2011

It is suggested that TDF or zidovudine (AZT) be used instead. But those drugs are relatively expensive: according to the health advocacy organisation, Médecins Sans Frontières (MSF), d4T is available for as little as $20 (R204) a patient a year, compared with $75 (R764) a patient a year for AZT and $57 (R581) a patient a year for TDF...read the full article

http://www.journaids.org/index.php/blog/blog-entry/drug_row_sparked_by_hiv_spending/