Decreased HIV plasma titer in response to combined low-dose zidovudine and acyclovir therapy in CDC class IVA patients.

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Decreased HIV plasma titer in response to combined low-dose zidovudine and acyclovir therapy in CDC class IVA patients.

Int Conf AIDS. 1990 Jun 20-23;6(1):139 (abstract no. Th.B.24). Unique Identifier : AIDSLINE ICA6/10002490
Coombs RW; Collier AC; Chaloupka K; Corey L; University of Washington, Seattle, Washington, USA

Abstract: OBJECTIVE: To measure the virologic response of low-dose zidovudine (300 versus 600 mg/day) with or without acyclovir (4800 mg/day) in CDC class IVA disease. METHODS: Twenty-two CDC class IVA patients enrolled in ACTG protocol 010 received zidovudine Q4H po at either 50mg (N=5) or 100 mg (N=5) per dose with (N=7 and 5, respectively) or without acyclovir 800 mg Q4H po. Blood specimens were obtained at baseline and at weeks 4, 8, 16 and 24 for plasma HIV titer and serum HIV-p24 antigen (Abbott, Chicago). Comparisons between baseline and week of therapy used Wilcoxon signed-rank analysis with Bonferroni correction and comparison by drug regimen used multivariant analysis. RESULTS: At baseline 17/22 (77%) were plasma viremic (mean ln titer +/- 1SD, 2.95 +/- 2.55) and 16/22 (72%) were p24 Ag positive. The mean plasma HIV titer declined to 1.26 (P=0.012) and to 1.15 (P=0.008) at weeks 4 and 8 post-therapy but rose to 1.69 (P=0.60) and 1.60 (P=0.36) at weeks 16 and 24. Mean p24 Ag levels were 116 pg/ml at baseline and 60 pg/ml at week 4 (P=0.068), 50 pg/ml at week 8 (P=0.004), 56 pg/ml at week 16 (P=0.036) and 65 pg/ml at week 24 (P=0.040). The change in plasma HIV titer and p24 Ag were not different between the four zidovudine-acyclovir regimens (P greater than 0.40). CONCLUSION: 300 mg daily of zidovudine was as capable as 600 mg daily of significantly lowering both the titer of plasma viremia and the level of p24 Ag. The effect on plasma viremia was not sustained beyond 8 weeks; however, the effect on p24 Ag was sustained for at least 24 weeks. The addition of acyclovir did not enhance the reduction of plasma viremia or p24 Ag. Further clinical trials with low dose zidovudine are warranted.

Keywords: Acyclovir/*THERAPEUTIC USE Drug Therapy, Combination Gene Products, gag/ANALYSIS Human HIV/*ISOLATION & PURIF HIV Antigens/ANALYSIS HIV Infections/*DRUG THERAPY Viral Core Proteins/ANALYSIS Viremia/*DRUG THERAPY Zidovudine/*THERAPEUTIC USE ABSTRACT
901230
M90C3694

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