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Mixed results on AZT's survival payoff.

The antiviral drug zidovudine (AZT) can prolong the lives of AIDS patients if treatment begins before AIDS symptoms emerge, according to a retrospective study of men infected with the AIDS-causisng HIV virus.

But this new finding, reported in the April 16 New England Journal of Medicine, runs counter to the results of a prospective study published earlier this year (SN: 2/15/92, p.100). The authors of the earlier study concluded that although early zidovudine treatment could delay the onset of AIDS symtoms, there was no evidence that such treatment could actually lengthen AIDS patients' lives.

In the latest study, epidemiologist Neil M.H. Graham of Johns Hopkins University in Baltimore and 34 colleagues analyzed the health records of 2,568 HIV-infected men who lived in Baltimore, Chicago, Pittsburgh, Los Angeles and Washington, D.C. The men were participants in the Multicenter AIDS Cohort Study, which began in 1984.

Graham's team found that men who received early zidovudine treatment were on-third less likely to die within two years than a second group of infected men who never took the drug or who took it only after developing AIDS symptoms. Those who took zidovudine early lived even longer if they also received the drug pentamidling to prevent pneumonia.

"Our results support the hypothesis that treatment before the development of AIDS increases an HIV-infected person's survival time," says Graham.

But John D. Hamilton, a principal author of the earlier report, contends that the new study is flawed. "Theirs is a comparison of early treatment versus essentially no treatment," he asserts. In that case, he says, "it is absolutely no surprise to show that early treatment is better."

Hamilton, an infectious-disease specialist at the Veterans Administration Medical Center in Durham, N.C., adds that even though his group's study used a smaller sample -- 338 HIV-infected men -- it directly compared patients receiving early treatment with those who received zidovudine only after developing AIDS symptoms. He and his colleagues remain "quite confident that early AZT does not provide a survival benefit versus late AZT," he says.
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Title Annotation:zidovudine
Publication:Science News
Article Type:Brief Article
Date:May 2, 1992
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