Anderson Peter L, Rower Joseph E
Department of Pharmaceutical Sciences at the University of Colorado Denver, Aurora, CO, USA.
Clin Med Rev Ther. 2010;2:a2004.
Zidovudine and lamivudine (ZDV and 3TC) are long-standing nucleoside analog-reverse transcriptase inhibitors (NRTIs) with extensive clinical experience in a wide spectrum of patients from in utero through childhood and adult ages. The safety profiles of both drugs are well-known and side effects for ZDV most commonly include nausea/vomiting, fatigue, anemia/neutopenia, and lipoatrophy; while 3TC is well-tolerated. ZDV-3TC is currently a viable alternative NRTI backbone for initial three-drug therapy of HIV infection when tenofovir disoproxil fumarate-emtricitabine (TDF-FTC) cannot be used because of a relative or absolute contraindication. ZDV-3TC continue to be viable alternatives for children, pregnant women and in resource limited settings where other recommended options are not readily available. ZDV-3TC penetrate the Central Nervous System (CNS) well, which makes ZDV-3TC attractive for use in patients with HIV-associated neurological deficits. Additional benefits of these drugs may include the use of ZDV in combination with certain NRTIs to exert selective pressure to prevent particular drug resistance mutations from developing, and giving a short course of ZDV-3TC to prevent resistance after prophylactic single dose nevirapine.
齐多夫定和拉米夫定（ZDV和3TC）是长期使用的核苷类似物逆转录酶抑制剂（NRTIs），在从子宫内到儿童期及成年期的广泛患者群体中有着丰富的临床经验。这两种药物的安全性概况广为人知，ZDV的副作用最常见的包括恶心/呕吐、疲劳、贫血/中性粒细胞减少和脂肪萎缩；而3TC耐受性良好。当因相对或绝对禁忌证而无法使用富马酸替诺福韦二吡呋酯-恩曲他滨（TDF-FTC）时，ZDV-3TC目前是用于HIV感染初始三联药物治疗的一种可行的替代NRTI骨干药物。对于儿童、孕妇以及在资源有限的环境中（在这些环境中其他推荐的选择不易获得），ZDV-3TC仍然是可行的替代药物。ZDV-3TC能很好地穿透中枢神经系统（CNS），这使得ZDV-3TC在治疗伴有HIV相关神经功能缺损的患者时具有吸引力。这些药物的其他益处可能包括将ZDV与某些NRTIs联合使用，以施加选择性压力来防止特定耐药突变的产生，以及给予短疗程的ZDV-3TC以预防单剂量奈韦拉平预防用药后的耐药性。
