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SHORT-TERM BENEFITS OF ZIDOVUDINE IN CHILDREN WITH AIDS.

By 1991, more than 20,000 children in the U.S. are expected to be infected with HIV and over 3000 will have developed AIDS. More than 80 percent of cases in children result from transplacental or perinatal transmission. In this study, 21 children (age 1 to 12 years) with symptomatic HIV infection acquired perinatally or through transfusions were treated with zidovudine (AZT) for one year or more.

Within 4 weeks of starting treatment, every child showed a substantial clinical response, which included increased appetite and weight, decreased adenopathy and hepatosplenomegaly, and increased numbers of CD4 lymphocytes. Most impressive is that clear improvement in neurodevelopmental abnormalities was documented in several patients by CT and PET scans, and in all patients by formal psychometric testing. All 13 children with AIDS encephalopathy showed significant improvement in IQ scores with treatment, as did five children without clinically apparent encephalopathy.

In contrast to past studies, in this study zidovudine was given by continuous intravenous infusion. While bone marrow suppression was frequent -- 14 patients required transfusions -- neutropenia generally could be avoided at zidovudine doses which still were effective against HIV. The long-term benefits of this therapy remain to be shown.

— ALK

Published in Journal Watch General Medicine October 11, 1988

Citation(s):

Pizzo P A; Eddy J; Falloon J et al. Effect of continuous intravenous infusion of zidovudine (AZT) in children with symptomatic HIV infection. N Engl J Med 1988 Oct 6 319 889-896.

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