Antiretroviral activity and pharmacokinetics properties of lamivudine and zidovudine association

Abstract

Lamivudine (3TC) and zidovudine (ZDV) are antiretroviral drugs used in the treatment of HIV infection. They are nucleoside analogues that inhibit HIV-1 reverse transcriptase. These drugs are anabolized intracellularly by a stepwise process and form an active triphosphate anabolite, which is used by HIV-1 reverse transcriptase and effectively terminates chain extension. The use of monotherapy is associated with a delay in the emergence of resistant mutants. The combination therapy would therefore seem to be potentially useful for rapid reduction in virus load. Adverse events were similar in both regimen, with the exception of lower incidence of anemia when used only 3TC. Both drugs are rapidly absorbed by passive diffusion through the intestinal wall. They are distributed into total body fluid and have a good bioavailability. They diffuse freely across the placenta from the maternal circulation to the fetal circulation. The glucuronidation is the main pathway of ZDV metabolism. About 60 to 70% of the drug undergoes biotransformation. The ZDV has a short elimination half-life from 1 to 1.5 hour. The 3TC is primarily eliminated unchanged through by renal excretion. A pharmacologically inactive trans-sulphoxide metabolite has been determined and corresponds to 5% to 10% of 3TC dose. The terminal elimination half-life of 3TC was from 8.5 to 11.5 hours.