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But criticism of the d4T trial goes beyond global equity. The March 2012 article from the Southern African Journal of HIV Medicine says the trial won't yield the results necessary to see whether 20mg of d4T is safer than the 30mg dose because it is a virological outcome study. This means that the main indicator is whether 20mg of d4T is as effective in suppressing HIV as 30mg of TDF, the current recommended dose for first-line treatment. Also, the two-year d4T treatment period makes it impossible to follow long-term side effects in patients, a key shortcoming as most people suffer from side effects if they continue d4T treatment for several years. The authors also note that, although previous trials of 20mg of d4T showed lower side effects, the rate was still "unacceptably high".
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