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Some HIV-infected people forgo AZT.

Some HIV-infected people forgo AZT

About half of all people who have asymptomatic or mildly symptomatic HIV infections, and who qualify for treatment with the antiviral drug AZT, do not take the drug, a new study suggests. Without AZT, they may risk faster progression to full-blown AIDS, many specialists warn.

In March 1987, the Food and Drug Administration approved AZT for people with advanced AIDS and for people infected with the AIDS-causing virus, HIV, who have fewer than 200 CD4 T-lymphocytes per cubic millimeter of blood. People with such low levels of these white blood cells -- which play an important role in the body's immune response -- become vulnerable to the lethal opportunistic infections associated with AIDS.

An epidemiologist at the Johns Hopkins School of Public Health in Baltimore and his colleagues now say many HIV-infected men apparently didn't get the message about the benefits of early AZT therapy.

Neil M.H. Graham and his team studied 1,195 HIV-infected men, some with AIDS-related complex (ARC) and others with no symptoms of the disease. All volunteers knew they were infected. Among people with CD4 counts below 200, the researchers found that AZT usage rose from 23 percent in April 1987 to 53 percent in September 1989. For people with ARC, usage increased from 20 percent to 54 percent during the same time period.

The good news is that AZT use is more common than before among people with very low CD4 counts, Graham says. But the researchers had expected to see a much larger percentage of such high-risk people taking the antiviral drug.

Graham says he can't explain the finding, but he speculates that AZT's price tag deterred some from taking the drug. Manufacturer Burroughs Wellcome Co. in Research Triangle Park, N.C., has since dropped the price, but during the study period the treatment cost as much as $8,000 per year. In addition, Graham says, infected people may put off taking it because they worry about developing early resistance to the drug. Others may fear discrimination, especially if they use employer-provided health insurance to help cover drug costs.

Graham plans a future study to find out more about AZT usage, especially now that scientists have shown the drug slows the progression to AIDS among asymptomatic HIV-infected people with CD4 counts below 500 (SN:8/26/89, p.135).
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Title Annotation:zidovudine
Author:Fackelmann, Kathy A.
Publication:Science News
Date:Jul 7, 1990
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