Treatment with Lamivudine, Zidovudine, or Both in HIV-Positive Patients with 200 to 500 CD4+ Cells per Cubic Millimeter

We studied the activity and safety of lamivudine plus zidovudine as compared with either drug alone as treatment for patients with human immunodeficiency virus infection, most of whom had not previously received zidovudine

Joseph J. Eron

2002

Scholarcy highlights

  • The reverse-transcriptase inhibitor lamivudine has in vitro synergy with zidovudine against the human immunodeficiency virus
  • In HIV-infected patients with little or no prior antiretroviral therapy, treatment with a combination of lamivudine and zidovudine is well tolerated over a oneyear period and produces more improvement in immunologic and virologic measures than does treatment with either agent alone.
  • Clinical studies indicate that its beneficial effects are limited in duration, partly because of the development of resistance by HIV
  • There is a need for potent, safe antiretroviral therapy, which may be achieved by using agents in combination
  • Patients who had had an illness considered to define the presence of the acquired immunodeficiency syndrome but who no longer required therapy for the acute illness were allowed to enroll in the study
  • There was no significant difference in effect between the combination-therapy groups or between the monotherapy groups
  • A persistent decrease in plasma tients who had serious adverse events attributed to any levels of HIV-1 RNA, by 0.8 to 1 log, was observed in cause or who were withdrawn from the study because the combination-therapy groups even through week 52
  • ZIDOVUDINE is the recommended initial therapy for human immunodeficiency virus infection and is generally tolerated well. clinical studies indicate that its beneficial effects are limited in duration, partly because of the development of resistance by HIV. Combination therapy with antiretroviral agents may have more sustained antiviral effects, decrease the emergence of drug resistance, and affect a wider range of cellular or tissue reservoirs of HIV infection. Studies evaluating treatment with a combination of two reverse-transcriptase inhibitors have found favorable effects on CD4ϩ counts and plasma viremia. Even in early, asymptomatic disease, there is substantial ongoing replication of HIV type 1, and turnover both of HIV-1 in plasma and of HIV-1–producing cells is generally high, with a halflife on the order of two days. There is a need for potent, safe antiretroviral therapy, which may be achieved by using agents in combination

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