AZT - Antiretroviral Treatment - AIDS/HIV

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Highly Active Antiretroviral Therapy

AZT has been hailed as the wonder drug in combating the progression of HIV.

It was the very first drug to be used against HIV and even today is still the main medication used to fight the virus – although it is now commonly used as part of a combination of drugs.

AZT (also known as Zidovudine, ZDV and Retrovir) is part of a group of medicines called antiretrovirals and was originally used to treat cancer patients as it was thought that cancer was a retrovirus.

It has actually been around since the early 1960s but it was only in 1985 that the drug was found to be effective against HIV by blocking the enzymes the virus uses to target and infect cells. Unfortunately it can’t help cells already infected.

The drug was approved a year later to fight HIV and in 1990 as a preventative treatment. Over the years, because AZT was the first anti HIV drug to be prescribed, there has been a great deal of research into it.

In the early days it was found that AZT as single drug therapy delayed the onset of AIDS by about two years. Subsequent research found that, given with another antiretroviral drug, AZT increased the number of years before the expected onset of AIDS by 50%. And in recent years aggressive three drug combination treatment has been found to increase that time period by 80%.

Certainly over the past decade, thanks to combination therapy, the reduction of AIDS-related deaths in areas where antiretrovirals are widely available have gone down dramatically and people with HIV are living longer.

Antiretrovirals are given not only to prevent the virus from damaging the immune system but also as a prophylactic to prevent opportunistic illnesses which could lead to full blown AIDS.

However, as with all drugs there are adverse side effects, the most serious being anaemia, muscle pain and weakness and an abnormally low number of infection fighting blood cells. Minor effects include nausea, vomiting and diarrhea.

AZT has not been without controversy. There have been some mumblings that AZT and other antiretroviral drugs like it are actually the cause of full blown AIDS.

This theory was mooted because some of the very rare side effects of the drugs (such as muscle wastage and anaemia) are also symptoms of AIDS. However, opponents of the theory argue that if AZT was the cause of AIDS how can we explain the fact that many people in developing countries such as Africa have AIDS without access to antiretrovirals?

AZT alone is widely given to pregnant women who are HIV+ as it has been found to be very effective in preventing mother to child transmission before during and after birth. However, because the drug has only been around two decades, very little is still known about its effect on a developing foetus. Some children whose mothers took AZT during pregnancy have been found to have reduced liver function and abnormally large craniums (the part of the skull enclosing the brain). The mental capacity in some of these children has also been found to be lower than normal.

This could be due to the AZT or not – the jury is still out.


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