Important note: Information in this article was accurate in September 2000. The state of the art may have changed since the publication date.
Results from early studies of anti-HIV drugs could find few significant differences in the effect of such drugs on men compared to women. This arose because such trials enrolled a relatively small proportion of women, compared to men.
In the early 1990s a large American study called ACTG 175 was conducted to compare the effect of combination therapy (two nukes) against AZT alone. Not surprisingly, ACTG 175 found that two nukes were more effective than AZT alone.
More recently, researchers have examined the data from that study to see if there were differences in the impact of nuke therapy between men and women. They found some significant differences, including the following:
Further differences appear in the rest of this report.
Researchers recruited nearly 2,500 subjects, about 18% of whom were women. A small proportion of subjects, about 15% (68 women, 298 men) had their viral loads measured during the study. At the start of the study the average viral loads in the subjects were as follows:
This difference between the two groups was statistically significant, that is, not likely due to chance alone. Moreover, this difference remained even when researchers divided subjects into groups with high CD4+ cell counts and low CD4+ cell counts.
Roughly equal proportions of men (54%) and women (53%) stopped taking their medication during the study. Among the women the group most likely to stop taking their medication prematurely were those women who had never used anti-HIV drugs before entering this study.
Among men there were no similar differences between those with prior use of anti-HIV drugs and those who had never used them before.
Women with no prior exposure to anti-HIV medication were significantly more likely than men to reduce the dose of their study medication - usually ddI.
Looking at side effects, women were twice as likely as men to report side effects affecting the brain and/or nerves.
Men were significantly more likely to have more abnormal lab values, particularly liver enzyme levels, than women. This trend occurred primarily among men with prior exposure to anti-HIV drugs.
Overall, men were more likely than women to have the following events occur:
Researchers are not sure why this difference occurred. They think that it may be related to the fact that women in this study generally had a lower viral load than men.
1. Currier JS, Spino C, Grimes J, et al. Differences between women and men in adverse events and CD4+ responses to nucleoside analogue therapy for HIV infection. J Acquir Immune Defic Syndr 2000 Aug 1;24(4):316-24.
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