Off-label drug use in human immunodeficiency virus disease

Article Abstract:

Many primary care physicians are treating complications of AIDS with drugs that have not been approved by the FDA for that condition. Such off-label use has been documented in cancer treatments. Researchers surveyed drug prescriptions among 387 primary care physicians for 1,148 HIV-infected patients. Forty percent of the approximately 5,000 prescriptions were for off-label conditions. Eighty-one percent of the patients received an off-label drug at some time during their treatment. However, most of this off-label prescribing was supported by drug compendia such as the AMA's Drug Evaluations, AHFS Drug Information and the USP DI. Those with an AIDS diagnosis received more off-label drugs than those who were asymptomatic. Seventy-nine percent of all drugs prescribed to prevent opportunistic infections were off-label. All of the drugs prescribed to treat wasting syndrome were off-label. But only 7% of the drugs prescribed to treat primary HIV infection were off-label.

Drugs, HIV infection, Drug therapy, HIV infections, Prescriptions (Drugs)

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Weight loss as a predictor of survival and disease progression in HIV infection

Article Abstract:

Weight loss by an HIV patient, whether mild or severe, seems to be associated with impending death. This may be connected with increased death risk or with increased risk of opportunistic infection. The increase in the relative risk of death for those who lost 5% to 10% of body weight over four months was significant. Opportunistic infections increased significantly in this group including cytomegalovirus infections, Pneumocystis carinii pneumonia, and Mycobacterium avium complex. For those who lost 0% to 5% of their body weight, risk was also increased.

Health aspects, Risk factors, HIV patients, Weight loss, Opportunistic infections

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Physician-assisted suicide and patients with human immunodeficiency virus disease

Article Abstract:

Some physicians appear willing to help people with AIDS die. Researchers surveyed 118 physicians who provide health care to AIDS patients in 1990 and again in 1995. In 1995, 48% said they would be likely or very likely to prescribe a lethal dose of a drug if the patient requested it, up from 28% in 1990. By 1995, over half the physicians had actually helped a patient commit suicide. Those who received the most requests for physician-assisted suicide or who had many patients who died were most likely to grant these requests.

Patient outcomes, Mortality, Physicians, Medical professions, Statistics, Surveys, Assisted suicide, AIDS patients

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