Mitochondrial toxic effects and ribavirin

Sir Similarly to Alain Lafeuillade and colleagues,1 we saw three cases of mitochondrial toxic effects in patients co-infected by HIV-1 and hepatitis C virus (HCV) and treated by highly active antiretroviral therapy and interferon alfa and ribavirin for their HCV. In murine models, the efficacy of di...

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Bibliographic Details
Published in:The Lancet (British edition) 2001-06, Vol.357 (9270), p.1803-1804
Main Authors: Salmon-Céron, Dominique, Chauvelot-Moachon, Laurence, Abad, Sébastien, Silbermann, Benjamin, Sogni, Philippe
Format: Article
Language:English
Subjects:
Adult
Anti-HIV Agents - adverse effects
Antiretroviral agents
Antiviral Agents - adverse effects
Didanosine - adverse effects
Drug dosages
Drug Interactions
Hepatitis
Hepatitis C - complications
HIV Seropositivity - complications
HIV Seropositivity - drug therapy
HIV-1
Humans
Interferon
Middle Aged
Mitochondria
Mitochondria - drug effects
Pancreatitis
Pancreatitis - chemically induced
Patients
Ribavirin
Ribavirin - adverse effects
Toxicity
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Summary:Sir Similarly to Alain Lafeuillade and colleagues,1 we saw three cases of mitochondrial toxic effects in patients co-infected by HIV-1 and hepatitis C virus (HCV) and treated by highly active antiretroviral therapy and interferon alfa and ribavirin for their HCV. In murine models, the efficacy of didanosine but also its toxic effects could be majored by ribavirin.3,4 In vivo, workers in a phase I and II trial done in 18 HIV-1-infected patients receiving didanosine alone (400 mg four times daily) for 4 weeks, then didanosine plus ribavirin for 8 weeks showed a significant decrease in HIV-1 viral load during the bitherapy period but also grade II-IV toxic effects in four (22%) patients during the first 12 weeks.5 Two of the 12 patients who followed their treatment for 20 weeks developed a biological pancreatitis that regressed when didanosine was stopped. If prospective studies confirm that the coadministration of didanosine and ribavirin leads to an increased risk of mitochondrial toxic effects, this could lead to new recommendations for the modalities of prescription of these two drugs, by reducing the dose of didanosine when coadministered with ribavirin or by avoiding their concomitant prescription.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(00)04921-7