EARLY AZT USE DEFENDEDAIDS researcher Paul Volberding and his colleagues at theUniversity of California, San Francisco, on Thursday presenteddata at the Ninth International AIDS Conference in Berlinfrom clinical studies that support the early use of the anti-viral drug AZT in treating HIV infection .

Their conclusions come in the midst of a debate about when toadminister AZT to HIV-infected individuals and over the drug'sultimate effectiveness in staving off active disease progression.

Results from a recent European study, known as the Concordestudy, question the working premise that "sooner is better" inAZT drug therapy. Concorde researchers claimed that thebenefits of early AZT administration are at best limited andtransient, and provide no real survival benefit.

Volberding's presentation focused on long-term data fromasymptomatic patients followed in a U.S. AIDS Clinical TrialsGroup (ACTG) study.

Volberding demonstrated that when AZT is taken early in thecourse of HIV infection (when the CD4 count is 300-500 perml.), the drug remains effective longer than when it is takenlater in infection, as evidenced by CD4 cell counts of fewer than300.

In the initial phase of the study, which was placebo-controlledfor about one year, only half of the patients received AZT.Thereafter, all patients were given the drug. A long-termfollow-up (about two and a half years) of these patientsdemonstrated that AZT significantly delayed the developmentof symptoms and progression to AIDS.

Patients who had fewer than 300 CD4 cells and had taken AZThad an average of one and a half years more symptom-freetime than those on placebo, but the patients who had 300-500CD4 cells had as much as three to four years more time withoutsymptoms than those on placebo.

"The bottom line is that the higher a person's CD4 lymphocytecell count when you start treatment, the more durable thebenefit of AZT when compared to placebo," Volberding said. --Jennifer Van Brunt

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