Zidovudine use in AIDS-Free HIV-1-seropositive homosexual men in the multicenter AIDS cohort study (MACS), 1987-1989

Neil M.H. Graham*, Scott L. Zeger, Victor Kuo, Lisa P. Jacobson, Sten H. Vermund, Wohn P. Phair, Roger Detels, Charles R. Rinaldo, Alfred J. Saah

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

Abstract

Zidovudine use data were examined in the Multicenter AIDS Cohort Study to determine (i) if the proportion of pre-AIDS participants (i.e., CD4+ cells <2OO/mm3 or AIDS-related complex) taking zidovudine is high enough to explain a slower than expected rise in AIDS incidence in U.S. homosexual men since mid-1987; (ii) which factors are associated with starting zidovudine and clinical trials of zidovudine; and (iii) if pre-AIDS patients, as a group, are being undertreated. Data on zidovudine use, clinical trial participation, and sociode-mographic, clinical, and hematologic variables were collected every 6 months from 1, 195 AIDS-free HIV-1-seropositive homosexual men from April 1987 to September 1989. Overall prevalence of zidovudine use rose from 3.6% in mid-1987 (visit 7) to 23% in mid-1989 (visit II). Of those with <200 CD4+ lymphocytes/mm', the prevalence of zidovudine use rose from 23% (24% if those taking zidovudine or placebo as part of a clinical trial are included) at visit 7 to 58% (69%) at visit 11. Of those with ARC, 20% (23%) were using zidovudine at visit 7 and 55% (65%) at visit 11. Although numbers were small, the advanced ARC participants (CD4+ cells <200/mm3 and two or more symptoms) reported the highest treatment rates (50. 78, 80, 60, and 74% at visits 7-11, respectively). By September 1989, 42% (31%) of those with CD4+ lymphocyte levels <200/mm1 were still not receiving zidovudine, suggesting that many high-risk, pre-AIDS individuals are being undertreated. To explore this finding further, we examined a range of sociodemographic, hematologic, and clinical variables to determine which factors best predicted.

Original languageEnglish (US)
Pages (from-to)267-276
Number of pages10
JournalJournal of Acquired Immune Deficiency Syndromes
Volume4
Issue number3
StatePublished - Mar 1991

Keywords

  • Epidemiology
  • HIV-1
  • Homosexuality
  • Incidence
  • Pentamidine
  • Therapeutic use
  • Zidovudine

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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