Failure of zidovudine prophylaxis after accidental exposure to HIV-1

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From: The New England Journal of Medicine(Vol. 322, Issue 19)
Publisher: Massachusetts Medical Society
Document Type: Article
Length: 218 words

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Abstract :

A placebo-controlled trial (one involving an inactive drug) of the prophylactic effects of zidovudine (AZT) has begun to assess its ability to prevent AIDS in people who are accidentally exposed to HIV-1 (human immunodeficiency virus, the virus associated with AIDS). AZT is the only drug currently approved for treating AIDS in the United States. A tragic mistake in a hospital allowed examination of this issue in a most direct manner. A 58-year-old monogamous heterosexual man, hospitalized for an intestinal problem, was inadvertently transfused with a minute amount (100 to 200 microliters) of blood from a homosexual man who was infected with HIV-1. Zidovudine treatment was begun within 45 minutes after transfusion, and was continued for several months. An antigen (foreign substance) associated with HIV-1 was detected in the patient's blood 30 days after the transfusion; HIV-1 antibodies appeared in the blood at 41 days, and the patient's lymphocyte counts dropped. Although zidovudine is currently recommended for accidental exposure to HIV-1, it does not appear that the drug prevented infection in this case. On the other hand, an accidental needle stick would result in a much smaller inoculum of virus than the 100 microliters that this patient received; it is possible that zidovudine could be an effective prophylactic in such cases. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Gale Document Number: GALE|A9023477