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AZT Dose Posted: Aug 9, 2006 QUESTION: I have a patient who has been on Combivir and Viramune for a while, doing quite well. He had hypertriglyceridemia which has responded to Lopid nicely. Recently he has developed marked anemia with Hgb of 9.9. Hemoccult is negative. Colonoscopy two years ago was negative. MCV is 127. Iron studies are normal. B12 and folate are normal. He gives a history of having been on Procrit for "AZT-associated anemia" and of responding nicely. I have started him on Procrit for now. He's content with his regimen. I thought about changing to 3TC+TDF+Viramune or to decreasing the dose of AZT to 150 mg TID. What's your experience with the latter? Thank you.


RESPONSE FROM: This sounds like a good case for AZT-associated anemia. If all other plausible causes of new onset anemia have been addressed (as they appear to have), a switch to a tenofovir (TDF, Viread)-based regimen should significantly help (as was shown in the recent COMET clinical study). I'd be a little uneasy with the unusual dose reduction of AZT (for reasons of efficacy), and I'm not convinced that this will help the anemia. BY

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