In the 2010 revision of the Guidelines on Antiretroviral Therapy (ART) for human immunodeficiency virus (HIV) infection in adults and adolescents, the World Health Organization (WHO) gave recommendations of the need for countries to phase out stavudine-based regimens because of the drug’s long-term irreversible side effects. The important toxicities associated with stavudine (d4T) included those associated with mitochondrial toxicity such as lactic acidosis, hepatic steatosis, peripheral neuropathy and lipoatrophy. WHO suggested using zidovudine (AZT) or tenofovir (TDF)-based first-line regimens instead of stavudine.
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