Treatment of HIV infection. Tolerability of commonly used antiretroviral agents

Abstract

There are a number of agents available that are active against HIV. Eight drugs are already licensed in the US: the nucleoside analogue reverse transcriptase inhibitors--zidovudine, didanosine, zalcitabine, stavudine and lamivudine--and the HIV protease inhibitors--saquinavir, indinavir and ritonavir. Antiretroviral drugs have been given as monotherapy, often as sequential monotherapy, and in alternating or simultaneous combinations. Since combination therapy has recently been shown to be superior to monotherapy, antiretrovirals will increasingly be given in combination. All available antiretroviral drugs show considerable toxicity complicating their use. In this article we describe the adverse effects of the above mentioned nucleoside analogues used in monotherapy and of several combinations of antiretroviral drugs. No unexpected toxicities were found in several different combinations tested to date and, for most combinations, no synergistic toxic effects have been reported.