Stein DS, Graham NM, Park LP, Hoover DR, Phair JP, Detels R, Rinaldo C, Saah AJ; National Conference on Human Retroviruses and Related Infections.
Program Abstr First Natl Conf Hum Retrovir Relat Infect Natl Conf Hum Retrovir Relat Infect 1st 1993 Wash DC. 1993 Dec 12-16; 149.
Division on AIDS/NIAID, Bethesda, MD.
Objective: To examine the effect of ACV use on disease progression in ZDV treated HIV+ individuals. Methods: 786 HIV+ homosexual men in the MACS who started ZDV prior to clinical AIDS, of whom 515 subsequently took ACV, were followed semiannually for AIDS-free and survival times. Intent to treat Cox models were fit to determine the relationship between use of ACV and disease progression controlling for prognostic variables. These covariates were included as either baseline (prior to ZDV; platelet count, hemoglobin) or as time dependent (ACV, CD4, PCP prophylaxis, HIV symptoms, clinical herpes episodes, and other antiretroviral therapy). AIDS-free and survival times were calculated from the first use of ZDV and included visits 7- 17 (1987-92). Results: Any reported use of ACV (ACV-any) was not associated with an effect on AIDS-free time but had a borderline effect on survival (RH=0.73, P=0.058). Use of ACV for an HIV indication (ACV-HIV) was not associated with an effect on AIDS-free time, but significantly improved survival (RH=0.64, P=0.01). We examined dose, constancy, and timing of ACV use to further investigate these findings. The median dose of ACV-HIV was between 600-800 mg. There was no apparent dose effect on survival. Longer uninterrupted ACV- any was associated with longer survival (greater than or equal to 3 consecutive visits RH=0.82, P=0.23; greater than or equal to 4 consecutive visits RH=0.72, P=0.09; cumulative visits on ACV RH=0.93, P=0.03). ACV-any or ACV-HIV was significantly associated with longer survival if used postAIDS (any,RH=0.58, P=0.02; HIV, RH=0.56, P=0.004) but not pre-AIDS (any,RH=1.09, P=0.65;HIV, RH=0.78, P=0.27). Conclusions: More uninterrupted use of ACV, especially after clinical AIDS, is associated with more prolonged survival. Definitive clinical trials are warranted.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Acyclovir
- Antigens, CD4
- Disease Progression
- Drug Interactions
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Proportional Hazards Models
- Survival
- Zidovudine
- immunology
Other ID:
UI: 102214480
From Meeting Abstracts