James Mason, M.D., quickly pointed out, though, that, "This new drug is not a cure, but it constitutes an important addition to the expanding group of antiviral drugs currently available, including AZT and DDI, for treating people with AIDS."

Description: ddC is a nucleoside analog drug designed to treat HIV. The pharmacological action of zalcitabine is to prevent the AIDS virus from replicating or reproducing before T-Cells (immune cells) are infected. Specifically, dideoxynucleoside analogs inhibit reverse transcriptase by terminating replication. Replication is terminated when an analog is incorporated into a growing DNA molecule because the 3'OH of the sugar has been removed, thereby precluding chain extension (see structure above).

Side Effects: Serious side effects include neurological complications (slight tingling and/or pain in the hands and feet). Inflammation of the nerves is called peripheral neuropathy and is a serious side effect. Symptoms include a burning or numbing in he hands or feet. Severity can vary from mild symptoms to a serious pain that makes walking hard. This condition usually vanishes when Zalcitabine is no longer taken. Other side effects include: pancreatitis, rash, oral ulcers, decreased blood platelet counts, abnormal liver function, skin eruptions, canker sores, and fever.

Managing Side Effects: If neuropathy results, drug usage must be discontinued. Antidepressants seem to alleviate peripheral neuropathy. Alternative medicine, such as acupuncture, also seems to help some.

Dosage: Adults take 2.25 mg a day total. This is taken in three doses that should be divided evenly and spaced evenly throughout the day.

Efficacy: The drug must be taken constantly to control an infection to prevent illness. If viral resistance builds and you become resistant, Zalcitabine usage may be discontinued.

Price: For 100 .75mg Tablets (3/day, lasting approximately 33 days), Hivid (Zalcitabine) costs $198.76. (www.planetrx.com)

Studies: Viani RM. "HIV Phenotypes in Children Treated with Zalcitabine." J Infect Dis. 1998; 177: 565-570.
Viani et al. Showed that zalcitabine resistance in children is rare despite prolonged treatment.