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The Toxicity Effects Of Stavudine ( D4t )

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Review of the toxicity effects of Stavudine (d4t) and Zidovudine (azt) in hepatocytes during HIV therapy.
Introduction
Since the outbreak of HIV/AIDS, an estimated 78 million people have acquired HIV and has killed approximately 39 million people infected with the virus. The prognosis of the epidemic has continued to vary from different countries and according to global statistics; 35 million people in 2013 were living with HIV/AIDS. 2.5 million People per annum acquire the virus and 1.5 million die of AIDS. Inspite of the drastic transmission of the HIV/AIDS epidemic, the development and accessibility of anti-retroviral drugs has decreased mortality rates by 22% from a population of 2.0million in 2009 to 1.5million in 2013 (WHO, 2013), …show more content…

Fig 1. Structure of HIV-1. Adopted from eMedWiki.
The HIV life cycle occurs in six stages namely; Fusion, Reverse transcription, Integration, transcription, assembly, and budding. Inorder for the virus to proceed to each stage and continue to replicate into new viral cells, it requires catalytic enzymes such as reverse transcriptase (RT), Intergrase (IG), and protease (PT). These replicating enzymes and cycle phases have been identified as potential therapeutic drug targets for HIV-therapy (Fig 2), therefore leading to the development of novel anti-retroviral drugs as stated below;
Fusion Inhibitors (FIs) and Entry inhibitors (EIs): They prevent entry of the viral capsid into the host CD4+ T cell, by inhibiting the viral Gp41 and Gp120 from binding and fusing with chemocokine coreceptors CCR5 or CXCR4 on the surface of the host cell. This further prevents the release of viral replicating enzymes (reverse transcriptase, Intergrase, and protease) from the viral capsid into the host cell. (Wilen et al., 2011). Examples are Enfuvirtide (FIs) and Maraviroc (EIs).
Reverse transcriptase Inhibitors (RTIs): There are 3 different classes of RTI and these include nucleoside RTIs (NRTIs), Non-nucleotide RTIs (NNRTIs), and nucleotide RTIs (NTRTIs). Inorder to exhibit their pharmacological effects,

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