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Stavudine resistance: an update on susceptibility following prolonged therapy

P F Lin1, C J González, B Griffith

  • 1Bristol-Myers Squibb, Wallingford, Conn., USA. linp@bms.com

Antiviral Therapy
|February 22, 2000
PubMed

Insights

Stavudine resistance in clinical HIV isolates is infrequent and modest, even after prolonged therapy. This finding supports stavudine

Area of Science:

  • Virology
  • Infectious Diseases
  • Pharmacology

Background:

  • Prolonged stavudine therapy is used for HIV treatment.
  • Understanding drug resistance is crucial for effective HIV management.

Purpose of the Study:

  • To summarize available data on stavudine resistance in clinical HIV isolates.
  • To evaluate the degree and frequency of stavudine resistance after extended treatment.

Main Methods:

  • Phenotypic evaluation of drug sensitivity in patient isolates.
  • Analysis of reverse transcriptase (RT) gene sequences for mutations.
  • Comparison of pre- and post-treatment isolates.

Main Results:

  • Most patients showed minimal changes in stavudine sensitivity.
  • Few isolates exhibited increased EC50 values, often without corresponding RT mutations.
  • No consistent RT amino acid changes linked to stavudine resistance were identified.
  • The V75T mutation was rare and did not correlate with resistance.

Conclusions:

  • Stavudine resistance is uncommon and generally modest in clinical settings.
  • Observed resistance patterns differ significantly from other nucleoside analogues.
  • These findings support stavudine's utility in first-line HIV combination therapy.

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