Comparison of Serum Transaminases and CD4 Counts in HIV Patients on ART Regimens Containing Zidovudine versus Stavudine

Abstract

Introduction: There has been a significant reduction in the mortality and morbidity associated with AIDS, due to the availability of highly active retroviral therapy (HAART). However adverse drug reactions related to ART use makes the treatment challenging. Aim of the study was to compare serum transaminases in HIV patients on two regimens; zidovudine versus stavudine, either of them administered in combination with nevirapine and lamivudine as well as to compare their efficacy, taking basal CD4 counts and after treatment CD4 counts as tools of comparison. Methods: A retrospective observational study on 46 adult HIV patients, receiving AZT+3TC+NVP (ZLN) (group I) and 22 patients on D4T+3TC+NVP (SLN) (group II) was carried out. Data of baseline CD4 cell counts, serially monitored CD4 count values (once in 6 months) and serum transaminases were noted. Statistical analysis was done by using SPSS version 16. Results: A very significant elevation of transaminases was observed at 6 months and 1 year in ZLN group (P<0.01). CD4 counts were also significantly high (P<0.05). SLN group didn’t show any significant differences in liver enzymes and CD4 counts at 6 months and 1 year. Extent of elevation of CD4 count was higher in ZLN group. Conclusion: Zidovudine based regimen was associated with mild elevation of liver enzymes as compared to stavudine based regimen. Improvement in CD4 counts was better with zidovudine regimen. Zidovudine, even though associated with mild hepatotoxicity, was found to be beneficial.