Zidovudine was licensed in March after trials showed that a dose of mg per day reduced opportunistic infections and increased CD4 counts and survival among people with AIDS, when compared to placebo over 24 weeks. Fischl, However, longer-term follow-up of this study failed to show a benefit of zidovudine over placebo. Fischl, Later studies confirmed that the lower dose of mg per day resulted in similar anti-HIV effects but with less toxicity. Fischl, A pill or liquid which looks and tastes exactly like a real drug, but contains no active substance.
A single change in gene sequence. The largest single study of zidovudine monotherapy in asymptomatic HIV infection, known as Concorde, suggested that there was no advantage in starting zidovudine before symptoms develop in the longer term. Almost participants were randomly assigned either to start taking mg zidovudine a day in four doses, or to receive a placebo until they developed symptoms or until they chose to switch from trial capsules to open zidovudine because of falling CD4 cell counts.
The results showed that after three years there was no detectable difference between immediate versus deferred use of zidovudine in terms of disease progression, development of AIDS or survival, but that the patients treated immediately had more severe side effects. Concorde Co-ordinating Committee. Numerous other studies examined the effect of zidovudine monotherapy at various doses and in patients at various stages of HIV infection throughout the late s and early s.
However, these studies revealed that adding another NRTI delayed both disease progression and death, paving the way for combination therapy in the treatment of HIV infection. Later studies demonstrated the efficacy of a combination of three antiretrovirals that included zidovudine.
Zidovudine may be taken twice or three times a day. Most people generally find twice-daily regimens easier to manage. The daily dose is or mg. Zidovudine is usually taken as one mg capsule twice a day, but mg capsules are also available for dose variations. A reduced dose of mg twice a day may also be safe and effective in patients with low body weight of less than 60kg.
Cressey A mg capsule has been discontinued in the United Kingdom due to low demand. Zidovudine is also available as a syrup and as a solution for infusion into a vein. Zidovudine may be taken with or without food. However, to achieve maximum zidovudine levels in the body the drug should be taken on an empty stomach, although this is not essential.
The commonest side effects of zidovudine are nausea, vomiting, diarrhoea, stomach pains, headache, dizziness,weakness and muscle pain. These often occur in the early weeks of treatment. Medicines to control nausea and headache can be prescribed before starting zidovudine. When first prescribed, zidovudine was given in high doses, which commonly caused severe side effects. Antiviral Therapy ;9 5 AIDS ;18 7 Improvement in lipoatrophy associated with highly active antiretroviral therapy in human immunodeficiency virus-infected patients switched from stavudine to abacavir or zidovudine: the results of the TARHEEL study.
Clinical Infectious Diseases ;38 2 Lancet ; Toxicity of antiviral nucleoside analogs and the human mitochondrial DNA polymerase. Journal of Biological Chemistry ; 44 In vivo antagonism with zidovudine plus stavudine combination therapy. Journal of Infectious Diseases , ; 1 Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment.
New England Journal of Medicine ; 18 A double-blind, placebo-controlled trial. New England Journal of Medicine ; 4 Do you work in HIV or hepatitis C? Can daily use of cannabis help to reduce the frequency of injecting opioids? Study uncovers health issues and concerns of some aging HIV-positive people. Production of this Web site has been made possible through a financial contribution from the Public Health Agency of Canada.
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AZT zidovudine, Retrovir. Alphabetical fact sheet listing Categorized fact sheet listing. Print-friendly PDF. What is AZT? How does AZT work? Continue to practice safer sex and take other precautions so as not to pass HIV on to other people. Women and childbirth AZT is also used to help prevent the transmission of HIV from mother to child during pregnancy and childbirth.
The current standards for pregnant HIV-positive women include: Taking AZT orally, mg twice daily or mg three times daily, beginning 14 to 34 weeks into the pregnancy and continuing at least until birth. Receiving intravenous AZT during labour, until delivery. Oral infant doses of AZT given to the baby, beginning eight to twelve hours after birth and continuing for six weeks.
Warnings 1. Anemia and bone marrow toxicity AZT can be toxic to the bone marrow—the soft tissue inside bones where blood cells are made. AZT was once the only treatment for AIDS, and it remains an important treatment, particularly in preventing the transmission of the virus from infected mothers to their unborn children.
Researchers knew almost from the beginning that the virus developed resistance to AZT, and that this resistance had to do with mutations, but the way the mutations worked to resist the drug was mysterious. About 10 years ago, biochemical studies in several laboratories established that AZT-resistant HIV-1 reverse transcriptase uses adenosine triphosphate, or ATP, which moves energy around inside the cell, to remove the AZT. Clark Jr. This terminates the synthesis of the DNA copy of the virus's RNA genome, preventing integration into the host and blocking viral replication.
The approval of AZT inspired a flurry of interest among drugmakers. Other reverse transcriptase inhibitors soon hit the market, followed by drugs that inhibit HIV protease enzymes required for host cell invasion. Although AZT's initial approval was met with widespread enthusiasm, controversy over its pricing wasn't far behind. In response to growing public outcry and stiff competition from cheap generic versions of AZT-based therapies, GlaxoSmithKline eventually began offering its AZT-based therapies to poor nations at significant discounts.
Still, critics charge, AZT-based therapies remain too expensive for most of the estimated 39 million people who now live with HIV worldwide. Contact the reporter. Submit a Letter to the Editor for publication. Engage with us on Twitter. The power is now in your nitrile gloved hands Sign up for a free account to increase your articles. Or go unlimited with ACS membership.
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