title: Long-term zidovudine treatment of asymptomatic HIV-1-infected subjects.
abstract: Eighteen asymptomatic men with persistent human immunodeficiency virus type 1 (HIV-1) p24 antigenemia were treated with zidovudine 250-500 mg (+/- acyclovir 800 mg) 6-hourly for 4-12 weeks, and thereafter with zidovudine 500 mg (+/- acyclovir 1600 mg) 12-hourly for 92 weeks. Six additional HIV-1 p24 antigenemic subjects were treated with zidovudine 500 mg 12-hourly for 76 weeks. Disease progression occurred in 4 subjects, despite sustained reduction of serum HIV-1 p24 antigen levels: Pneumocystis carinii pneumonia was diagnosed after 60, 80, 90 and 93 weeks, respectively. The median CD4+ cell count of these 4 men at study entry was 0.2 x 10(9)/l, and it declined to 0.07 x 10(9)/l at the moment AIDS was diagnosed. In 20 subjects no disease progression occurred. The median CD4+ cell count of these 20 men at study entry was 0.4 x 10(9)/l and it was 0.45 x 10(9)/l at the end of the study period. Median serum HIV-1 p24 antigen levels at the end of the study period were 42% lower than at study entry in these 20 subjects. In 5/20 men, an initial decline was followed by a rise in antigen levels to above pretreatment value. Treatment with zidovudine was well tolerated. Anemia caused symptoms in 3/24 men, but prolonged leucopenia or neutropenia did not occur. None developed clinical or convincing biochemical evidence of zidovudine-associated myopathy.
authors.affiliation: Department of Internal Medicine, University of Amsterdam, The Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: Mulder
authors.forename: F
authors.initials: F
authors.lastname: de Wolf
authors.forename: J
authors.initials: J
authors.lastname: Goudsmit
authors.forename: P A
authors.initials: PA
authors.lastname: Cload
authors.forename: R A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: A P
authors.initials: AP
authors.lastname: Fiddian
authors.forename: P T
authors.initials: PT
authors.lastname: Schellekens
authors.forename: J
authors.initials: J
authors.lastname: van der Noordaa
authors.forename: J M
authors.initials: JM
authors.lastname: Lange
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D015683:Gene Products, gag / Q000032:analysis; D015488:HIV Antigens / Q000032:analysis; D016655:HIV Core Protein p24; D015497:HIV-1; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011020:Pneumonia, Pneumocystis / Q000150:complications; D013997:Time Factors; D014758:Viral Core Proteins / Q000032:analysis; D015215:Zidovudine / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D015683:Gene Products, gag; D015488:HIV Antigens; D016655:HIV Core Protein p24; D014758:Viral Core Proteins; D015215:Zidovudine