home *** CD-ROM | disk | FTP | other *** search
- Document 2811
- DOCN M94A2811
- TI Acyclovir/zidovudine combination therapy and AIDS survival. Multicenter
- AIDS Cohort Study.
- DT 9412
- AU Stein DS; Graham NM; Park LP; Hoover DR; Phair JP; Detels R; Ho M; Saah
- AJ; Johns Hopkins University, Baltimore, MD 21205.
- SO Int Conf AIDS. 1994 Aug 7-12;10(1):22 (abstract no. 060B). Unique
- Identifier : AIDSLINE ICA10/94369764
- AB OBJECTIVE: To examine the effect of acyclovir use on disease progression
- and survival in zidovudine treated HIV + individuals. METHODS:
- Prospective cohort study of gay and bisexual men seen semiannually.
- Intent to treat Cox models were fit to determine the relationship
- between use of acyclovir (modelled as a time dependent covariate) and
- disease progression controlling for baseline (hemoglobin, platelets) and
- time dependent (CD4 count, HIV symptoms, PCP prophylaxis, herpes
- episodes, and other antiretroviral therapy) prognostic variables.
- AIDS-free and survival times were calculated from the first use of
- zidovudine (n = 786). Acyclovir use was defined as acyclovir-any (n =
- 488; acyclovir use for herpes or HIV) or acyclovir-HIV, (n = 242; HIV
- indication only: postulated to have higher dose, less intermittent use).
- RESULTS: Acyclovir was not associated with effects on progression to
- AIDS or CMV. Acyclovir-any was associated with a 26% decrease in risk of
- death (RH = 0.74, P = 0.07) and acyclovir-HIV was associated with a 36%
- decrease in risk of death (RH = 0.64, P = 0.01). Greater constancy, but
- not dose of acyclovir use was related to better survival. Acyclovir-any
- and acyclovir-HIV were significantly associated with a 44% decreased
- probability of death if used post-AIDS (P = 0.007 and P = 0.005
- respectively), but not pre-AIDS. Landmark analysis, using multivariate
- Cox models, gave estimated median survival times of 1018, 745 and 544
- days for men with CD4 count < 50 or AIDS comparing those who started
- acyclovir at or prior, either never or after, and never, respectively
- after the landmark point. CONCLUSIONS: Consistent use of acyclovir in a
- dose sufficient to suppress herpetic recurrences (600-800 mg/d) may have
- a significant impact on prolonging survival.
- DE Acquired Immunodeficiency Syndrome/*DRUG THERAPY/MORTALITY
- Acyclovir/*ADMINISTRATION & DOSAGE Cohort Studies Drug Therapy,
- Combination Herpesviridae Infections/PREVENTION & CONTROL Human HIV
- Seropositivity/*DRUG THERAPY Leukocyte Count Male Multivariate
- Analysis Prospective Studies Survival Analysis T4 Lymphocytes
- Zidovudine/*ADMINISTRATION & DOSAGE MEETING ABSTRACT
-
- SOURCE: National Library of Medicine. NOTICE: This material may be
- protected by Copyright Law (Title 17, U.S.Code).
-
-