Two studies of therapies for AIDS-related infections appear in the March 16 The New England Journal of Medicine. All information about the studies, done by the AIDS Clinical Trials Group (ACTG) of the National Institute of Allergy and Infectious Diseases (NIAID), is embargoed until 6 p.m. Eastern Time, Wednesday, March 15, 1995. To pursue stories on these two studies, please call the NIAID Office of Communications, (301) 402-1663.
Three Therapies Prevent Pneumonia (ACTG 081)
In patients with advanced HIV infection, three treatments have similar effectiveness in preventing Pneumocystis carinii pneumonia (PCP). Investigators assessed the risks for developing PCP during 36 months of therapy among more than 800 patients with HIV and 200 or fewer CD4+ T cells per cubic millimeter of blood. CD4+ T cells are the infection-fighting cells targeted by HIV. The risk for developing PCP was 18 percent among patients taking trimethoprim-sulfamethoxazole (TMP/SMX), 17 percent for those receiving dapsone and 21 percent for those on aerosolized pentamidine therapy. For patients with fewer than 100 CD4+ T cells, therapies that start with TMP/SMX or high dose dapsone are superior to treatments beginning with pentamidine. Authors note, however, that the greatest gains in preventing PCP will likely come from identifying more people at risk of the disease, rather than optimizing therapy for patients already receiving care.
Fluconazole Prevents Fungal Infections (ACTG 981)
Fluconazole was more effective than clotrimazole in preventing fungal infections in patients with advanced HIV infection, particularly those with 50 or fewer CD4+ T cells. In a substudy of ACTG 081 patients, researchers found that fluconazole reduced the frequency of cryptococcal meningitis, esophageal candidiasis as well as superficial fungal infections.