Behaviour of different clinical, immunological and serological parameters observed in a group of HIV positive patients during a 12 month treatment period with zidovudine.
During a 12 month open clinical trial, 14 patients (6 with AIDS, 2 with ARC and 6 with PGL) were continuously administered a daily 1200 mg dose of Zidovudine. Clinical course was correlated with a number of serological (HIV p24 antigen, p17 and p24 antibodies) and immunological (CD4 cell counts, serum neopterin and beta 2-microglobulin levels) parameters. All patients survived until the end of the trial: none developed major opportunistic infections, but 5 required an average of 7 blood transfusions each. Disappearance of p24 Ag was observed in 4 out of 7 patients, although with a subsequent reappearance in 3; moreover, changes of p24 Ag and HIV core Ab profiles were generally paralleled by neopterin and, to a lesser extent, by CD4/neopterin ratio variations. In the long run, significant differences between baseline and end-point results were shown by neopterin, but not by CD4 cell counts and beta 2-microglobulin levels. Efficacy of Zidovudine therapy seemed to be mainly related to clinical, but even more so, to immunological and serological status at baseline; in fact, severe clinical deterioration was observed in 2 patients who had an already low CD4/neopterin ratio from the beginning, coupled with a p24 Ag positivity and a negativity of both anti-p17 and -p24. Conversely, a stable clinical condition was observed in those patients in whom the reverse was true.
Crocchiolo
P R
PR
Infectious Diseases Department, Ospedale Maggiore, Lodi, Italy.
Lizioli
A
A
Arcidiacono
I
I
Cantaluppi
P
P
Filippi
C
C
Sobatti
D
D
Bedarida
G
G
D'Agostino
F
F
Cambie
G
G
Nardella
M L
ML
D000386:AIDS-Related Complex / Q000188:drug therapy; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D001708:Biopterins / Q000031:analogs & derivatives / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D016655:HIV Core Protein p24 / Q000032:analysis; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D019798:Neopterin; D016896:Treatment Outcome; D015215:Zidovudine / Q000627:therapeutic use*; D001613:beta 2-Microglobulin / Q000032:analysis
D015483:HIV Antibodies; D016655:HIV Core Protein p24; D001613:beta 2-Microglobulin; D001708:Biopterins; D015215:Zidovudine; D019798:Neopterin