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NLM AIDSLINE
Zidovudine delays development of AIDS for patients with 4c-2, 3 and 4a HIV disease.
Rachlis A; Bonner M; Fletcher M; Houle L; Sunnybrook Medical Centre and
September 30, 1990
Int Conf AIDS. 1989 Jun 4-9;5:411 (abstract no. W.B.P.360). Unique

OBJECTIVE: To establish drug use patterns and the rate of progression to AIDS in a group of 4C-2, 3 and 4A patients treated with Zidovudine. METHOD: A group of patients was followed for at least 6 months in the Ontario Canada open Zidovudine treatment study: 136 4C-2 patients, 67 category 3 patients and 23 patients in category 4A. RESULTS: At a mean follow-up of 38.5 weeks, 75% of the sample remained on Zidovudine at full or reduced dose. On average, of each 100 days, patients received full dosage for 30 days, a reduced dose for 40 days and had therapy suspended for 30 days. The majority of dose reductions and discontinuations were due to drug-related hematologic toxicity. Eight patients experienced 4C-1 opportunistic infections (OIs): 6 developed PCP and 2 had CMV disease. One had died at follow-up. Patients with previous 4C-2 OIs had AIDS diagnosed at a mean of 249 days after the original minor OI. For the rest of the 4C-2 patients the mean number of days without major infection was 512. The following did not appear to be predictive of progression to AIDS: anemia, thrombocytopenia, neutropenia or a severely depressed CD4 count at entry or the length of time at a reduced dose or time off Zidovudine. CONCLUSION: Progression to AIDS for 3.5% of the sample duplicates results of the initial placebo-controlled trial and is lower than rates obtained from historical controls. Of note is the fact that patients were at reduced dose or off the drug for 70% of the follow-up period. Further study is warranted to establish if a lower, less toxic dosage is, in fact, an efficacious one.

Acquired Immunodeficiency Syndrome/COMPLICATIONS/*PHYSIOPATHOLOGY CD4-Positive T-Lymphocytes Human HIV Infections/COMPLICATIONS/*DRUG THERAPY/PHYSIOPATHOLOGY Leukocyte Count Opportunistic Infections/COMPLICATIONS Zidovudine/ADVERSE EFFECTS/*THERAPEUTIC USE ABSTRACT

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