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M94A2843.TXT
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1994-10-25
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Document 2843
DOCN M94A2843
TI Impact of AZT monotherapy versus sequential or combination
antiretroviral therapy on survival.
DT 9412
AU Thompson M; Creagh T; Rimland D; Thompson S; Toomey K; AIDS Research
Consortium of Atlanta, Inc., Georgia.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):212 (abstract no. PB0279). Unique
Identifier : AIDSLINE ICA10/94369732
AB OBJECTIVE: To examine the impact of AZT mono- vs sequential or
combination antiretroviral therapy on survival. METHODS: Data from the
Georgia cohort of the CDC-sponsored Adult Spectrum of Disease Study were
analyzed. The cohort includes HIV-infected adults enrolled since 2/1/90
from the offices of 32 private practices and 3 public clinics. Data are
collected by chart abstraction at 6-month intervals. 5,300 patients have
been followed for a median of 36 months. Antiretroviral (AR) therapy was
categorized as: AZT monotherapy (received only AZT in > or = 3
consecutive 6-month intervals), sequential (received ddC or ddI
following AZT, but not in the same interval after initiation), or
combination (received ddC or ddI with AZT in > or = 3 consecutive
intervals). RESULTS: 2019 patients met the above AR criteria.
Proportional hazards analyses revealed no independent effect of gender,
race, or transmission mode when stratified by CD4 count at initiation of
AZT therapy. Product limit survival analyses were compared by logrank
test. There was no significant difference in survival between sequential
AZT/ddC and AZT/ddI or between combination AZT/ddC and AZT/ddI in any
CD4 category. Survival times at 36 months for different strategies vs
AZT monotherapy were as follows: TABULAR DATA, SEE ABSTRACT VOLUME. Many
fewer patients were maintained for three intervals on combo AZT/dddI
than combo AZT/ddC, and this may have biased the analysis of the combo
AZT/ddI strategy. DISCUSSION AND CONCLUSIONS: Sequential and combination
AR therapy with AZT/ddC or AZT/ddI conferred a survival benefit compared
with AZT monotherapy in some CD4 categories. Analyses comparing
sequential with combination therapy are not presented because of the
possibility of confounding by different levels of AZT intolerance
between the groups.
DE Adult Cohort Studies Comparative Study Didanosine/ADMINISTRATION &
DOSAGE/THERAPEUTIC USE Drug Therapy, Combination Georgia/EPIDEMIOLOGY
Human HIV Infections/*DRUG THERAPY/MORTALITY Proportional Hazards
Models Survival Analysis Treatment Outcome Zalcitabine/ADMINISTRATION
& DOSAGE/THERAPEUTIC USE Zidovudine/ADMINISTRATION &
DOSAGE/*THERAPEUTIC USE MEETING ABSTRACT MULTICENTER STUDY
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).