Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To determine the compliance and tolerance with zidovudine (azidothymidine or AZT) therapy among poor, minority, and intravenous drug-using patients, data were collected on all AIDS and ARC patients followed for at least 4 weeks in a New York City Human Immunodeficiency Virus clinic. Ninety-nine patients received zidovudine, of whom 75% were males, 92% were minorities, and 59% had a history of intravenous drug use. Of the 99 patients, 72 had AIDS and 27 had ARC with T-helper (CD4) lymphocytes less than or equal to 500 mm3. Eighty-seven of the 99 patients (88%) were compliant with zidovudine therapy. Fifty-seven percent of these had at least one adverse drug reaction requiring dose reduction (44%) or cessation (13%). Adverse reactions were similar to those reported in other populations with HIV-related illness, although headache and nausea were less common. Twenty opportunistic infections (OIs) or HIV-related malignancies occurred in 15 of 82 (18%) patients who were on zidovudine for at least 4 weeks (7.6 OIs/1,000 patient weeks). Seven of the 82 died (9%), compared to 9 of the 17 patients (53%) who did not complete 4 weeks of zidovudine therapy (p less than 0.05). There were no significant differences in any of these measures when intravenous drug users were compared with other risk groups. We conclude that zidovudine can be administered to intravenous drug users and others in an inner city clinic with acceptable compliance and tolerance.
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PMID:Zidovudine therapy in an inner city population. 238 64

The purine analog 2',3'-dideoxyinosine (ddI), which has anti-retroviral activity in vitro was administered for up to 42 weeks to 26 patients with acquired immunodeficiency syndrome (AIDS) or severe AIDS-related complex (ARC). Ten of these individuals were AZT-intolerant. Eight dose regimens were studied. The drug was orally bioavailable and penetrated into the cerebrospinal fluid (CSF). Comparatively little evidence of an effect against human immunodeficiency virus (HIV) was seen at the lowest four doses. However, patients in the four highest dose groups (ddI at 1.6 milligrams per kilogram intravenously and then greater than or equal to 3.2 milligrams per kilogram orally at least every 12 hours or higher) had increases in their circulating CD4+ T cells (P less than 0.0005), increased CD4/CD8 T cell ratios (P less than 0.01), and, where evaluable, more than an 80% decrease in serum HIV p24 antigen (P less than 0.05). The patients also had evidence of improved immunologic function, had reduced viremic symptomatology, and gained a mean of 1.6 kilogram with these comparatively infrequent dosing schedules (every 8 or 12 hours). The most notable adverse effects directly attributable to ddI administration at the doses used in this study included increases in serum uric acid (due to hypoxanthine release) and mild headaches and insomnia. These results suggest that serious short-term toxicity at therapeutic doses is not an inherent feature in the profile of agents with clinical anti-HIV activity. Further controlled studies to define the safety and efficacy of this agent may be worth considering.
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PMID:In vivo activity against HIV and favorable toxicity profile of 2',3'-dideoxyinosine. 250 40

Seventeen HIV-1-infected individuals were given AZT (100 mg tid) and ddC (0.375 mg tid) for consecutive periods of four weeks each and for total periods ranging from 8 to 32 weeks (median 17). Thirteen patients were offered AZT/ddC after having received other anti-retroviral combinations containing AZT, whereas in four it was used as front therapy. Before and after AZT/ddC, the median CD4 cell count changed from 184 to 164/uL (p NS), and the median body weight from 60 to 61 kg (p NS). Increases in hematological parameters were observed in patients previously exposed to AZT. In eight patients the side effects of AZT (gastrointestinal intolerance, cephalalgia and fever) disappeared when switched to ddC, whereas in one a reversible peripheral neuropathy ensued. The dosages of AZT/ddC used in this trial were well tolerated.
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PMID:[Sequential dideoxycytidine and zidovudine in advanced HIV-1 infection. Phase II study]. 839 11

The nucleoside reverse transcriptase inhibitor 3TC (lamivudine) appears to induce unusually prolonged HIV suppression when used in combination with AZT, according to the results of four randomized clinical trials. The studies showed that 3TC and AZT had similar antiviral effects when used alone. However, investigators observed a substantial, prolonged increase in CD4 counts and a significant decrease in HIV RNA when the drugs were administered simultaneously. These benefits persisted in all study groups for the 24-week study period, and in several for the six-month follow-up period as well. The combination was well-tolerated by nearly 1000 AZT-naive and AZT-experienced subjects enrolled in these trials, with the most common adverse effects being nausea, vomiting and headaches. A possible explanation for the antiviral effect is suggested by the mutation at HIV codon 184 that is frequently observed in virions exposed to 3TC for extended periods of time. In vitro studies have shown that this mutation confers 3TC resistance. It may also counteract other mutations that would normally lead to AZT resistance, therefore enabling virions exposed to both drugs to remain effectively susceptible to AZT.
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PMID:Combination 3TC/AZT therapy shows promise. 1136 92

Glaxo-Wellcome is developing a nucleoside analogue, 1529U89. The analogue shows potent in vitro activity against HIV, and initial tests of in-vivo efficacy are encouraging. The primary side effects of 1529U89 were nausea, headache, rash, and elevated liver function tests. Since the drug penetrates the central nervous system, participants are asked to allow spinal tips to measure the concentration of the drug in spinal fluid. Trials are being developed for 1529U89's use in AIDS-related dementia, and trials are being designed to test its effectiveness in combination with AZT and 3TC.
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PMID:A surprisingly potent nucleoside analogue. 1136 84

3TC can raise T4 counts and lower HIV levels, and its use may increase the effectiveness of AZT. Studies show that HIV levels decrease by more than 90 percent in people taking the 2 drugs in combination. Side effects are manageable, and few participants drop out of the studies. Another study showed that 3TC also lowered the amount of hepatitis B virus in the blood to a level where it could not be detected. Side effects include headache, nausea, fatigue, diarrhea, neuropathy, and lowered levels of both red and white blood cells. HIV cells can mutate and resist the effects of 3TC within a few weeks of beginning treatment. The manufacturer, Glaxo Wellcome, has a patient assistance program and an expanded access program for the drug.
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PMID:AZT and 3TC. 1136 95

It is critical to take HIV medications, particularly protease inhibitors, exactly as prescribed to reduce the risks of developing resistance. The Food and Drug Administration (FDA) recently approved a new drug, Combivir, a combination of 3TC (lamivudine) and AZT in one tablet. Combivir works by interfering with the HIV life cycle to prevent it from replicating, and is taken twice a day with or without food. Patients with low body mass, hepatitis, or liver or kidney disease should not take Combivir. Blood counts need to be monitored regularly when taking this drug. Potential side effects include headache, nausea, fatigue, diarrhea, nasal congestion, or flu-like symptoms. A phone number is provided for more information on Combivir.
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PMID:What you need to know about Combivir. 1136 67

HIV-positive individuals are at high risk of developing an anxiety disorder, with a prevalence rate as high as 38 percent. The symptoms may occur anytime during the course of the infection, and can become excessive in some patients, impairing the person's ability to cope with their circumstances. Signs and symptoms include chest pain, headache, numbness, and insomnia. HIV treatments that may cause anxiety symptoms include ddI, d4T, AZT, fluconazole, foscarnet, and isoniazid. Health care providers need to thoroughly evaluate anxiety symptoms during an initial evaluation to rule out substance abuse and pre-existing anxiety. Treatment of anxiety in HIV/AIDS ranges from benzodiazepines to alternative therapies such as massage and acupuncture. A chart lists potential drug interactions between common antidepressive and HIV antiretroviral drugs.
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PMID:Anxiety and HIV infection. 1136 9

Phase III data show that efavirenz (Sustiva, formerly DMP-266) is effective in suppressing viral load when used in combination with other treatments. A head-to-head comparison trial in volunteers with little or no previous antiretroviral experience shows that efavirenz may suppress viral load as well as Indinavir (Crixivan). Efavirenz is an experimental non-nucleoside reverse transcriptase inhibitor (NNRTI), and widespread consensus seems to accept it as a valid treatment for AIDS. The most noteworthy trial result showed that using it in combination with AZT plus 3TC suppressed viral load to below 400 copies in a significant number of volunteers, with few patients dropping out. Viral load remains low at 72 weeks, but not much information is available on those patients who were more heavily pre-treated. Other combinations also appear effective. DuPont Pharmaceuticals, the manufacturer, says common side effects include rash, nausea, diarrhea, headache, and insomnia, and cautions against widespread use in pregnant women. Efavirenz is unlikely to work in patients who have developed resistance to either Nevirapine or Delavirdine, two other NNRTI drugs.
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PMID:Efavirenz (Sustiva) may equal or exceed protease inhibitor in initial antiretroviral combination. 1136 99

[Name removed] settled her lawsuit against a physician whom she claimed misdiagnosed her with AIDS. [Name removed] went to the doctor with a low-grade fever, swollen glands, headaches, coughing, and digestive problems, and told the doctor she had previously received a positive HIV test result. The doctor did not confirm the HIV test, but treated her with AZT and other drugs for more than 2 years. In the trial, [name removed] admitted that one of the doctor's colleagues had offered her an HIV test, but she refused. Terms of the settlement are sealed.
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PMID:Lawsuit settled. 1136 87


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