AIDS-HIV Treatment Briefs: AZT Vs ddI

AIDS-HIV Treatment Briefs: AZT Vs ddI

Step Perspective, Volume 5, Number 1; A Publication Of The Seattle Treatment Education Project - February 1993

The long-awaited results of the clinical trial comparing AZT and ddI in individuals with little or no previous antiviral therapy (ACTG 116A) have finally been released. Researchers, physicians, and individuals with HIV had hoped that this trial would answer the question of which antiviral, AZT or ddI should be used as "first-line" therapy. However, the results this study produced are not quite so clear-cut; they are rather complex. The trial included a total of 617 individuals who either had an AIDS diagnosis or advanced ARC, and CD4 counts of less than 300 or who were asymptomatic and had CD4 counts of less than 200. These individuals were randomly assigned to receive either 500 mg per day of ddI, 750 mg per day of ddI, or 600 mg of AZT. All individuals in the trial had either never used AZT before, or had used AZT for 16 weeks of less.

Of the 380 individuals with no prior AZT use, those who received 600 mg of AZT per day showed the least amount of disease progression. Only 18 percent of the AZT arm progressed to more serious illness or death, whereas 29 percent of the individuals receiving 500 mg of ddI and 31 percent of the individuals receiving 750 mg of ddI progressed.

Of the 119 individuals who had received AZT for eight weeks or less, those who received AZT showed slightly less disease progression than those who received ddI, but this difference was not statistically significant.

However, in an unexpected finding, it appeared that the 118 people who had taken AZT for eight to 16 weeks before switching to ddI did better than any other group. The one year progression rates for these individuals were 11 percent for 500 mg of ddI, 17 percent for 750 mg. of ddI, and 33 percent with AZT.

The researchers are not yet able to explain why just eight to sixteen weeks of initial therapy with AZT before switching to ddI led to such a significant difference in disease progression (29 percent progression with ddI alone versus 11 percent with ddI given after initial therapy with AZT).
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Always watch for outdated information. This article first appeard in 1993. This material is designed to support, not replace, the relationship that exists between you and your doctor.

Copyright © 1993 - Seattle Treatment Education Project (STEP) - All rights reserved. Noncommercial reproduction is encouraged. STEP is published four times a year by the Seattle Treatment Education Project, 127 Broadway East, 3rd Floor, Seattle, WA 98102. Email: step100@aol.com STEP web page

This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1993. AEGIS.