Talk:Zidovudine

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Attention: I'm a bit confused about the following paragraph in the article: "When used as a preventative treatment, AZT has proven to be particularly effective. If treatment is started before the total amount of virus, known as the viral load, reaches a critical point of 50 million parts per millilitre of blood serum, the chance of AIDS developing is effectively zero. This is widely used with medical practitioners who receive accidental infections."

Aren't two things being confused here? I'm not a doctor, but from what I've heard, antivirals given shortly after exposure (preferably within a few hours) to HIV virus can decrease the risk of becoming infected by about 80%. If succesful, the person would test negative on HIV tests. This treatment type is known as PEP. However, the article talks about treatment starting af 80 million copies/mL and claims this will decrease risk of getting full-blown AIDS to 0%. 80 million copies/mL seems like a fairly high number so I doubt that it can be PEP the paragraph is referring to (additionally, PEP doesn't decrease the risk to 0%). Rather, it seems the article is talking about the possibility that therapy initiation in the first weeks/months after infection (ususally when symptoms of acute HIV develops) will lower the viral set-point and improve long-term prognosis even after treatment is stopped (in this scenario the patient would still test positive on HIV tests). However, from what I've read, this is currently being researched and there's no solid evidence of this. So how could the risk be practically 0% as the paragraph claims? The best we can say that it delays onset by, say, 15 years because that is the longset people receiving early treatment has lived until now.

AIDS was actually considerably more widespread in Africa is rather presumptive. The criteria for labelling a case "AIDS" are much weaker (broader) in Africa than they are in North America. And it was not suggested AZT was the cause of AIDS, but a cause, under the substance-abuse rubric. Malnutrition and starvation -- long a problem in Africa, worse after "First World" and IMF resource stripping -- can also resemble the AID syndrome, and doubtless compound the effects of pollutants. -- Kwantus

Do they actually still prescribe this poison? I thought the 1993 Concorde study -- one of the only ones not funded by the manufacturers -- put an end to it when it showed AZT had a statistically higher death rate than placebo. 142.177.24.141 03:46, 27 Jul 2004 (UTC)

Yes, it's still being used, but nowadays usually not as monotherapy, and in smaller doses than in the Concorde study. The main finding of the Concorde study was, that they could find no benefit in taking the drug before the symptoms appear, ie. the progression to advanced disease wasn't affected.

I wouldn't call the difference in death rate (176/171) statistically higher (bad luck?). After all that was just one study, there are others that contradict. Here's a couple of sites on AZT safety: a WHO study, NIAID site and AEGiS. Daevatgl 18:22, Jul 27, 2004 (UTC)

In accordance with Wikipedia:WikiProject_Drugs naming policy, I propose we move this page to the INN zidovudine. If you have any concern with this proposal, please discuss it on this page. Matt 18:09, 23 Dec 2004 (UTC)

[edit] Patent issues section

That the Greg Palast book is cited in this article at all is reason enough to question its accuracy. First of all, the lawsuit to which the section presumably refers may have been aided by Public Citizen, but the actual title was Burroughs Wellcome Co. v. Barr Labs., Inc.,. Secondly, the line about the taxpayer footing the entire bill for the drug development is probably nonsense -- I assume that BW paid for the clinical trials (which are another massively expensive part of drug development) and the chemical engineering needed to scale up production (yet another oft-overlooked part). Since the case isn't online, I'll have to check back before changing anything. But it is cited in a few opinions that are online: search this opinion for 'AZT' to find one. jdb ❋ (talk) 06:45, 26 Mar 2005 (UTC)

[edit] Hungarian word "azt"

I cut this recent anonymous addition from the article, as it seems unlikely that an English-language encyclopedia would need an entry on the Hungarian word for "that":

Azt also means 'that' in Hungarian.

If an Englsh-language entry is desired for that word, it may be better to put it at wikt:azt instead. There is no entry in [hu.wiktionary.org The Hungarian Wiktionary] for it, though, and I don't speak Hungarian, so I'll let someone else write wikt:azt and wikt:hu:azt if they're important. The Rod 21:21, 9 January 2006 (UTC)

[edit] Martinez reference

I've cut the reference to this paper by M. Martinez. You can dispute anything you want if you cite Medical Hypotheses, which is not a peer reviewed journal. In any case the article is out of date. Trezatium 19:52, 5 April 2006 (UTC)

Just a quick reply I don't want to get into a debate. Medical Hypotheses isn't peer reviewed, but there are occassionally some good articles there. This particular citation is a good paper, and still valid despite being several years old. The article discusses the genetics of mutation and drug resistance as it relates to nucleoside analogs. These genetics don't change through the years, so still valid. The article points out a lack of laboratory evidence for drug resistance by nucleoside analog drugs. For example, lack of correlation between reverse transcriptase activity and drug resistance. Keep in mind the standard AIDS articles from the peer reviewed journals from the 1980s are still cited.mwtzz 15 June 2006

I'm afraid I don't have access to the full text of the article, but the abstract claims that, "laboratory techniques which test for viral sensitivity to the drugs fail to provide direct evidence for the existence of [drug resistance]." More recent studies of phenotypic and genotypic resistance tests appear to contradict this claim. Trezatium 18:54, 15 June 2006 (UTC)

Yeah but putting the cart before the horse isn't good science and puts into doubt the original theory. In other words, claiming HIV develops drug resistance, then providing the evidence years later ... mwtzz

What matters here is the current state of knowledge, not when that knowledge was acquired. Evidence of NRTI resistance is abundant. Trezatium 19:29, 15 June 2006 (UTC)