Can we predict neuropathy risk before stavudine prescription in a resource-limited setting?

A toxic sensory neuropathy associated with exposure to inexpensive nucleoside analogue reverse transcriptase inhibitors (NRTIs) [particularly stavudine (d4T)] causes dilemmas in the management of patients with HIV, especially in resource-poor settings. Here patients (n = 96) attending Pokdisus AIDS...

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Main Authors:	Affandi, J., Price, Patricia, Imran, D., Yunihastuti, E., Djauzi, S., Cherry, C.
Format:	Journal Article
Published:	Mary Ann Liebert, Inc. 2008
Online Access:	http://hdl.handle.net/20.500.11937/33904

id	curtin-20.500.11937-33904
recordtype	eprints
spelling	curtin-20.500.11937-339042017-09-13T15:08:56Z Can we predict neuropathy risk before stavudine prescription in a resource-limited setting? Affandi, J. Price, Patricia Imran, D. Yunihastuti, E. Djauzi, S. Cherry, C. A toxic sensory neuropathy associated with exposure to inexpensive nucleoside analogue reverse transcriptase inhibitors (NRTIs) [particularly stavudine (d4T)] causes dilemmas in the management of patients with HIV, especially in resource-poor settings. Here patients (n = 96) attending Pokdisus AIDS Clinic at the Cipto Mangunkusumo Hospital, Jakarta who had been treated with d4T were screened for symptomatic neuropathy. Clinical, demographic, and genetic factors were considered as possible neuropathy risk factors. DNA from saliva was used to examine alleles of TNFA-308, BAT1 (intron 10), TNFA-1031, IL1A+4845, and IL12B (3' UTR). The prevalence of neuropathy (symptoms and signs) was 34%. On multivariate analysis, neuropathy following d4T exposure was associated with increasing age, increasing height, and TNFA-1031*2 (model p = 0.0009). Isoniazid exposure (present in 56% of patients) was not associated with neuropathy in this cohort, where all patients had received pyridoxine coadministration. These data suggest that a simple algorithm based on patient age, height, and TNF genotype could be used to predict the individual's risk of symptomatic neuropathy prior to prescription of d4T. © 2008 Mary Ann Liebert, Inc. 2008 Journal Article http://hdl.handle.net/20.500.11937/33904 10.1089/aid.2008.0045 Mary Ann Liebert, Inc. restricted
repository_type	Digital Repository
institution_category	Local University
institution	Curtin University Malaysia
building	Curtin Institutional Repository
collection	Online Access
description	A toxic sensory neuropathy associated with exposure to inexpensive nucleoside analogue reverse transcriptase inhibitors (NRTIs) [particularly stavudine (d4T)] causes dilemmas in the management of patients with HIV, especially in resource-poor settings. Here patients (n = 96) attending Pokdisus AIDS Clinic at the Cipto Mangunkusumo Hospital, Jakarta who had been treated with d4T were screened for symptomatic neuropathy. Clinical, demographic, and genetic factors were considered as possible neuropathy risk factors. DNA from saliva was used to examine alleles of TNFA-308, BAT1 (intron 10), TNFA-1031, IL1A+4845, and IL12B (3' UTR). The prevalence of neuropathy (symptoms and signs) was 34%. On multivariate analysis, neuropathy following d4T exposure was associated with increasing age, increasing height, and TNFA-1031*2 (model p = 0.0009). Isoniazid exposure (present in 56% of patients) was not associated with neuropathy in this cohort, where all patients had received pyridoxine coadministration. These data suggest that a simple algorithm based on patient age, height, and TNF genotype could be used to predict the individual's risk of symptomatic neuropathy prior to prescription of d4T. © 2008 Mary Ann Liebert, Inc.
format	Journal Article
author	Affandi, J. Price, Patricia Imran, D. Yunihastuti, E. Djauzi, S. Cherry, C.
spellingShingle	Affandi, J. Price, Patricia Imran, D. Yunihastuti, E. Djauzi, S. Cherry, C. Can we predict neuropathy risk before stavudine prescription in a resource-limited setting?
author_facet	Affandi, J. Price, Patricia Imran, D. Yunihastuti, E. Djauzi, S. Cherry, C.
author_sort	Affandi, J.
title	Can we predict neuropathy risk before stavudine prescription in a resource-limited setting?
title_short	Can we predict neuropathy risk before stavudine prescription in a resource-limited setting?
title_full	Can we predict neuropathy risk before stavudine prescription in a resource-limited setting?
title_fullStr	Can we predict neuropathy risk before stavudine prescription in a resource-limited setting?
title_full_unstemmed	Can we predict neuropathy risk before stavudine prescription in a resource-limited setting?
title_sort	can we predict neuropathy risk before stavudine prescription in a resource-limited setting?
publisher	Mary Ann Liebert, Inc.
publishDate	2008
url	http://hdl.handle.net/20.500.11937/33904
first_indexed	2018-09-06T22:06:46Z
last_indexed	2018-09-06T22:06:46Z
_version_	1610897536510328832

Can we predict neuropathy risk before stavudine prescription in a resource-limited setting?

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