Treatment of the patients with intolerance to AZT by phosphazid

To estimate the possibility of using phosphazid (PhAZT) for the antiretroviral treatment of patients with intolerance to AZT. PhAZT is the new reverse transcriptase inhibitor which is approved for clinical application in Russia. As the preclinical and clinical study demonstrated PhAZT has the same antiretroviral activity but significantly less toxicity compared with AZT. Clinical and laboratory (immunological, haematological, biochemical) observation up to 48 weeks for the 47 patients with intolerance to AZT (grade 2-4 of toxicity) which the AZT was replaced on PhAZT. Twenty-one patients received AZT and then PhAZT as monotherapy and 26 patients as component of HAART, The intolerance to AZT was manifested as gastrointestinal manifestation (nausea, vomiting) in 19 patients, anaemia in 22 patients, granulocytopenia in six patients. Clinical and laboratory adverse events (AE) were registered and their connection with the therapy was estimated also. No case of serious AE or interruption of the treatment by PhAZT were observed. Gastrointestinal adverse events (slight nausea, grade 1 of toxicity) were observed in three patients (6.38%), anemia (grade 1 of toxicity) in one patient (2.1%). Granulocytopenia was not observed. The progression of HIV infection was observed in two patients with stage 3C by CDC classification. The mean value of CD4 cells at the moment of the change of AZT to PhAZT was 0.27*10 super(9)/l, after 4 weeks 0.29*10 super(9)/l, after 12 weeks 0.26*10 super(9)/l, after 24 weeks 0.31*10 super(9)/l, after 36 weeks 0.37*10 super(9)/l, after 48 weeks 0.34*10 super(9)/l. Increase of the CD4 level after 24 weeks was statistically significant. The replacement of AZT with PhAZT for patients with intolerance for AZT allows them to continue the antiretroviral therapy with success.