title: A comparison of zidovudine, didanosine, zalcitabine and no antiretroviral therapy in patients with advanced HIV disease.
abstract: Three nucleoside analogues, zidovudine (AZT), didanosine (ddI), and zalcitabine (ddC), are approved for use in the treatment of patients with HIV infection. This retrospective study compares the 3 drugs and examines the overall utility of antiretroviral therapy by way of comparisons to a no treatment (No Rx) group in patients with advanced HIV disease. Patients with advanced HIV disease were enrolled in didanosine (August 1989-December 1990) or zalcitabine (October 1990-February 1992) expanded access programmes; continued on zidovudine treatment despite fulfilling criteria for zidovudine failure or intolerance; or maintained on no antiretroviral treatment. Statistical analysis revealed that patients on nucleoside analogue therapy had fewer opportunistic infections (P = 0.001) than those who received no antiretroviral treatment. The Kaplan-Meier 12-month estimate of survival was significantly longer among patients who switched from zidovudine to zalcitabine but not among patients who switched to didanosine, when compared to the other 2 groups (P = 0.05).
authors.affiliation: AIDS Center, St Vincent's Hospital and Medical Center of New York, NY 10011, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Torres
authors.forename: M R
authors.initials: MR
authors.lastname: Barr
authors.forename: K I
authors.initials: KI
authors.lastname: McIntyre
authors.forename: J R
authors.initials: JR
authors.lastname: Thornton
authors.forename: W M
authors.initials: WM
authors.lastname: Shay
authors.forename: R D
authors.initials: RD
authors.lastname: Feldman
authors.forename: N J
authors.initials: NJ
authors.lastname: George
authors.forename: D J
authors.initials: DJ
authors.lastname: Britton
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D016049:Didanosine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016047:Zalcitabine / Q000009:adverse effects / Q000627:therapeutic use*; D015215:Zidovudine / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D015215:Zidovudine; D016047:Zalcitabine; D016049:Didanosine