Effectiveness of Zidovudine in Treatment of Advanced HIV Infection

Excerpt

Since the introduction of zidovudine, an inhibitor of retroviral reverse transcriptase, there has been continuing controversy regarding the usefulness of this agent. Questions have been raised about the optimal time to initiate therapy and about the duration of benefit achieved with this form of antiretroviral treatment. Preliminary findings of the Concorde trial,¹ a multicenter double-blind, randomized study, failed to demonstrate a significant benefit in survival or rate of disease progression in patients with immediate use of zidovudine therapy compared with deferred treatment. The guidelines promulgated by the expert panel convened after the results of the Concorde trial were presented attempted to address these issues using data from controlled clinical trials.² The panel suggested that antiretroviral therapy was optional in asymptomatic persons with CD4 lymphocyte counts of 0.20 to 0.50X10⁹/L (200 to 500/μL) but that zidovudine should be given to human immunodeficiency virus (HIV)-infected individuals who were