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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The findings from two clinical trials indicate that combination therapy is dramatically more effective that AZT monotherapy in prolonging life and inhibiting disease progression. The European-Australian Delta trial and an American study, ACTG 175, were designed to test the effectiveness of AZT plus ddI or ddC on clinical endpoints. All trial participants in the Delta study had to have a CD4 count between 50 and 350, and were randomly assigned a standard dose of AZT plus ddI, ddC, or placebo. The results of Delta indicate that patients who began their anti-HIV treatment with either combination had a substantially reduced risk of clinical progression or death compared to those receiving AZT monotherapy (placebo). Results from the arm of the trial for people who had already taken AZT (Delta 2) were less encouraging. Combination therapy was no more likely to cause serious side effects than AZT alone.
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PMID:AZT delta study: major European/Australian study finds combinations better than AZT alone. 1136 76

Two studies in first-line treatments for HIV infection, ACTG 175 and Delta, are examined. The results were presented at the 1995 International Conference on Antimicrobial Agents and Chemotherapy (ICAAC). ACTG 175 compared monotherapy with AZT or ddI, to combination therapy with AZT/ddC and AZT/ddI, and looked at the benefits of immediate versus delayed combination therapy. Delta compared AZT to AZT/ddI and AZT/ddC in AZT-naive or -experienced individuals with CD4 cell counts between 50 and 350. A table is provided summarizing each study's results.
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PMID:ACTG 175 and Delta. 1136 15

Critical commentary is provided on the ACTG 175 and Delta study findings concerning first-line HIV treatment. The findings are viewed as largely irrelevant in that they come at a time when new and more potent drugs are being added to the therapeutic arsenal. The findings do not provide information on the optimal time to start therapy or indicate when to switch regimens.
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PMID:Making sense of 175 and Delta. 1136 16

Two large trials, ACTG 175 and Delta, are showing that long-term monotherapy for HIV infection is outdated. Long-term monotherapy with AZT, recommended since 1993, is no longer defensible. ACTG 175 confirms the emerging theme of other studies, suggesting that the drug's efficacy is limited to one or two years. Options of what to switch to or what to add will be determined on an individual basis. The National Institute of Allergy and Infectious Diseases (NIAID) is expected to change treatment standards for antiretrovirals after the CPCRA 007 trial data is included.
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PMID:New trials reach same conclusion: two drugs are better than AZT alone. 1136 21

Developments on antiretroviral therapies for HIV infection from the 1995 Conference on Antimicrobial Agents and Chemotherapy are presented. Drug companies' investigative results concerning their protease inhibitors are discussed, followed by reviews of the ACTG 175 and Delta study results. Particular attention is given to AZT mono and combination therapy issues. Early viral marker data from ACTG 175, the value of combined marker data, vaccines and herpes episodes boosting HIV RNA, and the issue of when and how to do routine viral load testing are demonstrated. Information showing greater benefits of therapy in well-controlled clinical trials is provided, and a brief history of viral suppression is outlined.
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PMID:Closing the circle on HIV--or not. 1136 64

Research on HIV viral loads and combination therapy was presented at the 35th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). Research has shown that ten billion HIV particles are produced daily in an infected individual's body. The HIV particles live freely for about eight hours before infecting CD4 cells, which live for 2.2 days before dying. The virus replicates in about 1.2 days. This is a faster rate of replication than previously thought. The specific proteins needed for cytotoxic lymphocytes to recognize an infected CD4 cell may not be available with so many viral mutations constantly occurring. Combination therapies are believed to decrease drug-resistant strains of HIV by reducing replication and by increasing the number of mutation sites needed for new HIV virions to be produced. A research study, ACTG 175, compared four treatments: zidovudine (ZDV) alone, ddI alone, ZDV plus ddI, and ZDV plus ddC. The results showed that ZDV alone was the least effective treatment, even when it was the initial treatment. ZDV plus ddI was the most effective for people who had previously taken ZDV, and ZDV plus ddC was the most effective for ZDV-naive participants. Delta, a European and Australian trial, reported similar results.
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PMID:Review of viral load and combination therapy data from 35th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy. 1136 80

An extended follow-up of four European/Australian randomized trials of AZT in asymptomatic HIV-positive patients revealed that there was no overall benefit in starting AZT monotherapy immediately versus waiting until symptoms appeared. These findings are consistent with Delta and ACTG 175 trials. These trials evaluated different treatment strategies in a well-defined patient population based on CD4 criteria, with everyone receiving treatment immediately.
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PMID:Long-term follow-up of early AZT use. 1136 90

Presentation summaries from two 1995 conferences dealing with AIDS, the Thirty-Fifth Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and the Fourth Annual Women and HIV Conference, are presented. Highlights from ICAAC include discussions on HIV disease treatment issues, gynecologic concerns, obstetrics, and perinatal transmissions. Summaries from the Women and HIV Conference include a presentation on gynecologic care, how clinical trial data influence clinical practices, the implications from the ACTG 076 study on the effect of AZT on maternal-fetal transmission of HIV, and the use and success of traditional Chinese medicine.
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PMID:Conference news highlights. 1136 10

An interview with five experts on AIDS therapy, Dr. Robert Coombs, Dr. Scott Hammer, Dr. Michael Saag, Dr. Charles van der Horst, and Dr. Deborah Cotton, explores their impressions of the results from three large clinical trials. The trials--ACTG 175, Delta 1, and Delta 2--analyzed the efficacy of treatment with AZT alone compared to AZT combined with ddI or ddC, and ddI alone. Coombs states that the ACTG 175 results are the first convincing evidence of overall survival benefit with ddI compared with AZT alone. According to Hammer, the results suggest that AZT monotherapy may no longer be the optimal approach. Van der Horst said the results show that treatment outweighs no treatment, even at the beginning when CD4 counts are higher. Cotton observed that although the results show a benefit, she would not start therapy in an asymptomatic person. The experts also detailed what data they use to determine the best treatment to use for patients. Coombs said he uses the patient's CD4 cell count and clinical status, along with their viral load. Saag said his decision to treat asymptomatic patients is based on his understanding of how the virus causes disease and the pathogenesis of HIV infection.
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PMID:To treat or not to treat--approaches to antiretroviral therapy. Interview by Anthony J. Japour. 1136 56

The ACTG 076 clinical trial is examining AZT effectiveness at preventing mother to fetus HIV transmission. Preliminary studies embellished the results of this poorly designed and executed study. Initially, scientists were to collect data on 400 children borne of HIV-positive mothers, but data from only 75 were collected and the rest were extrapolated. It is suggested that participation was generated out of fear and coercion. Consent forms exaggerated infection ratios, stating that ninety percent of HIV-positive infants die within their first year. Actually, seventy to eighty percent of infants born to HIV-positive mothers are HIV-negative. Extensive AZT therapy in pregnant women is harmful. Vitamin A therapy has been suggested as a possible alternative for lowering the risks of HIV transmission.
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PMID:[Women yell at the results of 076]. 1136 23


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