These problems are being addressed by treating patients with combinations of drugs. Lamivudine, an analogue of cytidine, has been studied in combination with zidovudine. Both drugs act by inhibiting viral reverse transcriptase and lamivudine is active against strains which are resistant to zidovudine. Compared to zidovudine alone, the combination results in a significant increase in CD4 lymphocyte counts. Patients who have been previously treated with zidovudine also benefit.
Patients take lamivudine twice a day.
Food delays absorption. Adverse effects are common and similar to those seen in patients treated with zidovudine. The most common complaints are nausea, abdominal discomfort, headache, malaise and fatigue. Abnormal liver function tests and anaemia can occur during treatment. When lamivudine is used alone, resistant viral strains can develop rapidly.