The use of nukes - AZT, ABC (abacavir, Ziagen), ddI, d4T, 3TC, ddC - has been linked to various side effects, including the following:
These complications occur because nukes can damage the energy-producing parts of a cell called mitochondria. When mitochondria are damaged, the cell experiences a power failure and gets injured. Prolonged power failures can cause the cell to die.
Some PHAs who use particular nukes such as ddC, ddI and d4T - the "d" drugs - have developed nerve damage in the hands and/or feet, a side effect called peripheral neuropathy. It therefore should come as no surprise that researchers now suspect that nukes may cause damage to people's sense of hearing - something that is heavily dependent on nerves.
In an article that appeared in the June 1, 2001 issue of the journal Clinical Infectious Diseases, doctors in Denver, Colorado, reported on their investigation of hearing loss in three male PHAs. All subjects had experienced hearing loss before starting highly active antiretroviral therapy (HAART). This hearing loss occurred because of exposure to excessive noise. In the normal course of events, once people are no longer exposed to loud noise the loss of hearing stops - as was the case with all three subjects. However, shortly after they began taking anti-HIV medications, all three subjects reported ringing in the ears, or tinnitis, and their hearing loss resumed.
The doctors note that all three PHAs were between the ages of 47-53 years and would therefore have been at risk for developing hearing loss. As well, one PHA had low levels of vitamin B12 in his blood and also used the drugs trazodone (Trazorel) and valproic acid (Depakene), all of which are factors associated with hearing loss. Nevertheless, when these PHAs started HAART, their hearing loss was striking. Furthermore, when two of the subjects stopped taking HAART, their hearing partly improved.
Among HAART-users, the following factors may increase the risk of hearing loss:
Clearly, further studies are needed to confirm this finding as well as to find safer therapies with fewer side effects for PHAs.
REFERENCE
Simdon J, Watters D, Bartlett S and Connick E. Ototoxicity associated with use of nucleoside analog reverse transcriptase inhibitors: a report of three possible cases and review of the literature. Clinical Infectious Diseases 2001;32:1623-1627.
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Copyright © 2001 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284 http://www.catie.ca.
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