Abstract

New and Zidovudine Will It Remain • • • Drug Approvals Key Monotherapy for Asymptomatics? By Naomi Pfeiffer anticipated approval of two new antiretroviral agents, ddl and ddC, will add significantly to the range of available HIV therapies, according to leading AIDS researchers and clinicians. But zidovudine is likely to remain the single-agent therapy of choice for many patients, said experts interviewed to discuss the state of the art in treating HIVinfection. The new agents, now in phase II/III trials, offer alternatives for patients who are intolerant of zidovudine or show clinical deterioration on the drug. All three agents are nucleoside analogs with a similar mechanism of action against HIV but with different side effects. Anemia is the major adverse effect of zidovudine, pancreatitis of ddl, and peripheral neuropathy of ddC. However, with the dideoxynoleosides some overlapping toxicities have been seen. The "Single-agent therapy may continue to be the best way to treat early disease, just as it is in tuberculosis," he said. "We know that the duration of benefit from zidovudine increases substantially when intervene early." He tells patients with few or no symptoms that it might be better to spend a we antiretroviral agent for three