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Being Alive

MUCH ADO ABOUT THE CONCORDE: The Preliminary Results About AZT


Being Alive 1993 May 5: 3

The researchers published a summary and preliminary analysis of their three-year data as a letter in the April 3 issue of the top British medical journal The Lancet. The central finding reported was that after three years, there was no significant difference in survival or progression between the Immediate AZT and the Deferred AZT groups.

In sum, the three-year survival rate for the Immediate group overall was 92% and for the Deferred group 93%. There was also no difference when starting CD4 counts were taken into account and if one takes the non-HIV deaths out of the analysis.

If one compared the proportion of each group who survived three years and remained free of AIDS and free of significant symptoms, these are the results by starting CD4 levels: Immediate Deferred less than 200 16% 34% 200 to 500 63% 60% more than 500 85% 82% OTHER SIGNIFICANT POINTS IN THE REPORT INCLUDED: - There were no significant differences between the Immediate and Deferred groups in each T-cell stratum at the study's outset, in terms of risk group, immune activation laboratory markers, or time since first positive HIV antibody test.

- The Immediate (AZT) group had on average a 30-cell higher CD4 count than the Deferred or placebo group after 3, 6 and 12 months. This difference persisted for up to three years but was not associated with longer survival or slower progression. Concorde scientists felt this calls into question the validity of CD4 counts alone, independent of symptoms, as an adequate surrogate marker to assess drug therapy and other strategies of controlling HIV-related disease.

- Severe side effects were rare overall (even though the dose used was double the now-standard 500 mg/day) but higher in the Immediate group.

- The researchers say that their results are "not inconsistent" with the 019 and other, shorter AZT-favorable studies if one compares results at shorter time intervals. This presumably means that those on early AZT had a somewhat slower progression rate for the first 12-to-18 months, but this advantage was washed out by the time three years had gone by. 


Information in this article was accurate in May 5, 1993. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.