[Efficacy and safety of zidovudine in monotherapy in patients with HIV infection]. / Eficacia y tolerancia del tratamiento con zidovudina (ZDV) en monoterapia en pacientes con infección VIH.

BACKGROUND: To study the efficacy and the tolerance of the zidovudine (ZDV) in monotherapy for the treatment of a cohort of patients with HIV infection, most of them injection-drug users (IDU). METHODS: Retrospective study of a historic cohort of 350 patients, from January 1988 to December 1994. The clinic progression, the immunologic deterioriation and the survival after the ZDV administration were evaluated, like the toxicity of the drug. RESULTS: The estimated progression time to AIDS for the 25% of the cohort was 29 months for the initially asymptomatic patients and 22 months for the subjects who showed symptoms. After 26 months half of the patients showed CD4 cell counts less to 50% of the basals. The cumulative survival probability after a year was 99%, 97% and 85% for the groups A, B y C of the CDC classification, and 94%, 87% and 58% after two years for these groups. The predictive factors associated with the survival were the clinic and immunologic status, ESR, LDH, and beta 2-microglobulin levels at the beginning of the treatment. The 35% of the patients suffered adverse events, mainly hematologic effects, although they only forced to suspend the treatment in the 5% of the cases. The only predictive factor associated with the toxicity was a neutrophile count less than 1.500 cells/mm3 previous to the treatment (p < 0.001). CONCLUSION: The ZDV use in monotherapy in a cohort of patients majority IDU shows the same efficacy and safety as the treatment in other patients with HIV infection.