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ZIDOVUDINE IS EFFECTIVE IN ALL RACES.

concern that data from predominantly white patients with HIV infection may not apply to other racial or ethnic groups is likely to be eased by two large multicenter studies.

Lagakos and colleagues of the AIDS Clinical Trials Group pooled data on 2048 asymptomatic or mildly symptomatic patients with HIV infection (including 155 blacks, 190 Hispanics, 144 women, and 221 intravenous drug users) who participated in one of two randomized trials of zidovudine. Rates of progression to AIDS were higher in subjects who received placebo than in those receiving zidovudine, regardless of race, ethnicity, gender, or IV drug use. Although some subgroups were too small for zidovudine's effect to be statistically significant, the relative risk of AIDS in the placebo group was similar to that in non- Hispanic whites (about 2.0 to 4.0).

Easterbrook and colleagues from the Zidovudine Epidemiology Study Group compared the courses of AIDS or AIDS-related complex (ARC) in 754 white, 165 black, and 106 Hispanic patients who received zidovudine for up to two years. Among AIDS patients, two-year survival rates were lower in blacks (27 percent) than in whites (40 percent) or Hispanics (39 percent); blacks also had higher rates of Pneumocystis carinii pneumonia (PCP). However, outcomes for patients with ARC were similar among the three groups. Multivariate analysis indicated that the poorer prognosis of black patients reflected more advanced disease at the time zidovudine was started and less use of PCP prophylaxis.

These data support the use of similar HIV treatment strategies in all ethnic groups.

— THL

Published in Journal Watch General Medicine November 26, 1991

Citation(s):

Easterbrook PJ et al. Racial and ethnic differences in outcome in zidovudine-treated patients with advanced HIV disease. JAMA 1991 Nov 20 266 2713-2718.

• Medline abstract (Free)

Lagakos S et al. Effects of zidovudine therapy in minority and other subpopulations with early HIV infection. JAMA 1991 Nov 20 266 2709-2712.

• Medline abstract (Free)