February 24, 1994
Media Contact:Joann Rodgers
Phone: (410) 955-8659

One anti-AIDS drug AZT confers much of its protective effect shortly after starting treatment with the drug, but its benefits may continue even after the onset of AIDS symptoms, according to findings of a study of more than 2,000 infected men reported by researchers at The Johns Hopkins School of Public Health. The results appear in an article published in the February issue of the Journal of acquired Immune Deficiency Syndrome.

"Our results agree with those of two other studies that found that early therapy with AZT delayed AIDS onset or extended life," says Alfred J. Saah, MD., M.P.H., associate professor of epidemiology and the first author of the report. But, he adds, the results disagree with conclusions drawn from the 1993 Concorde study by English and French workers, which reported no benefit to early AZT therapy. "Our study shows that AZT works whether it's given before or after AIDS onset."

"The Hopkins study clears up the confusion," Saah says, "because it compares the results of early treatment, late treatment, and no treatment of HIV-positive men. "Now the patient and his doctor can decide whether to add more survival time when the patient feels well--before AIDS symptoms-or after the onset of symptoms," according to Saah.

AZT is traditionally given before AIDS symptoms appear, in order to slow development of the disease, but it also extends survival time when it's given after symptoms occur, according to Saah.

"AZT works effectively, regardless of when treatment begins," he points out. "Using AZT treatment early--before AIDS--gives the person some extra survival time once AIDS begins, but also extends the time before the first AIDS symptoms appear."

The Hopkins researchers also found three factors that predicted longer survival among men:

1. age of 37 years or younger;

2. levels of hemoglobin (the oxygen-carrying protein in blood) of at least 13 grams/100ml blood;

3. levels of CD4+ cells in their blood of at least 100 million per liter. CD4+ cells are a part of the body's defense against infection, which is crippled by the AIDS virus.

One study is important because it shows that even though a person acquires an AIDS symptom or illness while taking AZT preventively, he may still continue to receive some benefit from the drug," adds Lewis Schrager, M.D., the chief of the Epidemiology Section at the National lnstitute of Allergy and Infectious Diseases' Division of AIDS.

The men studied by Hopkins researchers were part of the Multicenter AIDS Cohort Study (MACS) in the greater metropolitan areas of Baltimore,/Washington, Chicago, Pittsburgh and Los Angeles. The men were either -positive (1,809), became HIV-positive (359), or developed AIDS (866) during the study.

The other authors of the study include Donald R. Hoover, Ph.D., M.P.H., associate professor of epidemiology; Yanhua He, M.S.; Lawrence A. Kingsley, Dr.P.H. (University of Pittsburgh), John P. Phair, M.D. (Northwestern University Medical SchooL Chicago), and the Multicenter AIDS Cohort Study.

-- JHMI --
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