Document 2843
 DOCN  M94A2843
 TI    Impact of AZT monotherapy versus sequential or combination
       antiretroviral therapy on survival.
 DT    9412
 AU    Thompson M; Creagh T; Rimland D; Thompson S; Toomey K; AIDS Research
       Consortium of Atlanta, Inc., Georgia.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):212 (abstract no. PB0279). Unique
       Identifier : AIDSLINE ICA10/94369732
 AB    OBJECTIVE: To examine the impact of AZT mono- vs sequential or
       combination antiretroviral therapy on survival. METHODS: Data from the
       Georgia cohort of the CDC-sponsored Adult Spectrum of Disease Study were
       analyzed. The cohort includes HIV-infected adults enrolled since 2/1/90
       from the offices of 32 private practices and 3 public clinics. Data are
       collected by chart abstraction at 6-month intervals. 5,300 patients have
       been followed for a median of 36 months. Antiretroviral (AR) therapy was
       categorized as: AZT monotherapy (received only AZT in > or = 3
       consecutive 6-month intervals), sequential (received ddC or ddI
       following AZT, but not in the same interval after initiation), or
       combination (received ddC or ddI with AZT in > or = 3 consecutive
       intervals). RESULTS: 2019 patients met the above AR criteria.
       Proportional hazards analyses revealed no independent effect of gender,
       race, or transmission mode when stratified by CD4 count at initiation of
       AZT therapy. Product limit survival analyses were compared by logrank
       test. There was no significant difference in survival between sequential
       AZT/ddC and AZT/ddI or between combination AZT/ddC and AZT/ddI in any
       CD4 category. Survival times at 36 months for different strategies vs
       AZT monotherapy were as follows: TABULAR DATA, SEE ABSTRACT VOLUME. Many
       fewer patients were maintained for three intervals on combo AZT/dddI
       than combo AZT/ddC, and this may have biased the analysis of the combo
       AZT/ddI strategy. DISCUSSION AND CONCLUSIONS: Sequential and combination
       AR therapy with AZT/ddC or AZT/ddI conferred a survival benefit compared
       with AZT monotherapy in some CD4 categories. Analyses comparing
       sequential with combination therapy are not presented because of the
       possibility of confounding by different levels of AZT intolerance
       between the groups.
 DE    Adult  Cohort Studies  Comparative Study  Didanosine/ADMINISTRATION &
       DOSAGE/THERAPEUTIC USE  Drug Therapy, Combination  Georgia/EPIDEMIOLOGY
       Human  HIV Infections/*DRUG THERAPY/MORTALITY  Proportional Hazards
       Models  Survival Analysis  Treatment Outcome  Zalcitabine/ADMINISTRATION
       & DOSAGE/THERAPEUTIC USE  Zidovudine/ADMINISTRATION &
       DOSAGE/*THERAPEUTIC USE  MEETING ABSTRACT  MULTICENTER STUDY

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).