Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc. - 29 Sep 1995
Lars Foyen

"We now know that a combination of drugs does make a difference and can achieve prolonged survival. This has produced much-needed enthusiasm in the field," Dr. Scott Hammer of Harvard Medical School told a news conference.

A joint European-Australian study presented at the conference showed that combining the common AIDS drug AZT with either of two related drugs, ddI or ddC, extended the lives of 38 percent of HIV sufferers by more than two years.

"The study shows it is possible to produce a dramatic fall in mortality over two years. This is certainly meaningful for patients," said Dr. Brian Gazzard of London's Chelsea and Westminister Hospital.

Newly-released U.S. research led by Hammer showed AZT, made by Glaxo Wellcome, worked better when combined with ddI, made by Bristol-Myers Squibb under the name of VIDEX, and ddC, made by Hoffmann-La Roche, a unit of Roche Holding Ltd.

Researchers said there was a clear consensus at the three-day gathering, the Fifth European Conference on Clinical Aspects and Treatment of HIV Infection, that a combination of drugs should be given to patients starting treatment.

But they also agreed there was no real cure in sight for the estimated 15 million HIV carriers in the world.

"A cure remains a distant and unlikely dream," said Gazzard, a coordinator of the European-Australian study, the so-called Delta trial.

It started in 1992 and involved more than 3,000 HIV sufferers in Australia, Britain, France, Germany, Ireland, Italy, the Netherlands and Switzerland.

They were randomly assigned one of three treatments -- AZT alone, AZT with ddI or AZT with ddC -- all similar drugs that attack the AIDS virus.

Of the patients who had never taken AZT before, 17 percent who took AZT alone died, compared with 10 percent who took AZT with ddI and 12 percent who took AZT with ddC.

A second group of patients had been taking AZT already. In this group, there was no clear benefit from combination therapy.

Earlier trials had shown that AZT, when used alone, did not help HIV patients live longer.

Dr. Hammer's U.S. study, the so-called ACTG 175 trial, confirmed the superiority of combination treatment and also found that ddI on its own was more efficient that AZT.

Contrary to the Delta trial, the results were the same whether or not participants had been previously treated with AZT. More studies were needed to determine which study was right, researchers said.

Doctors said combination therapy should be offered to up to 100,000 of Europe's estimated 500,000 HIV sufferers.

The millions of victims in Africa and Asia were unlikely to ever hear about the new drugs cocktail which is even more expensive than single drug therapy.

"There is enormous inequity in HIV treatment which is very embarassing for the rich countries. Maybe western countries should pay more for the drugs than the Third World does," Gazzard said.

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