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EARLY TREATMENT EXTENDS SURVIVAL IN HIV INFECTION.

Zidovudine treatment has been shown to improve survival in patients with AIDS. A new study suggests that zidovudine also extends life when used in early HIV infection, and that prophylaxis against Pneumocystis carinii pneumonia (PCP) provides additional benefit.

Investigators followed 2568 HIV-seropositive men without AIDS for up to 24 months and grouped them into different disease states based on CD4+ cell counts and symptoms. A multivariate analysis that controlled for disease state and use of PCP prophylaxis revealed that the use of zidovudine was associated with a significantly lower mortality rate. The relative risk of death ranged from 0.45 at 6 months to 0.70 at 18 months; no clear reduction in mortality was seen thereafter. Patients who received both zidovudine and PCP prophylaxis had significantly lower mortality at 24 months than those given zidovudine alone (relative risk, 0.60).

Although this was an observational study rather than a controlled trial, it was carefully designed, had complete follow-up information, and adjusted for confounding factors. It thus provides relatively strong evidence that early treatment in HIV infection extends life.

— ALK

Published in Journal Watch General Medicine April 28, 1992

Citation(s):

Graham NMH et al. The effects on survival of early treatment of human immunodeficiency virus infection. N Engl J Med 1992 Apr 16 326 1037-1042.

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