Quality of life in a placebo-controlled trial of zidovudine in patients with AIDS and AIDS-related complex

Article Abstract:

The Karnofsky Performance Status (KPS) was the first scoring system developed for the quantitative estimation of the ability of a patient to manage the simple chores of everyday life. The Quality of Well-Being scale (QWB) is a more recent measure, which attempts to quantify the quality of life that can be sustained by patients with incurable and terminal diseases. Practitioners who deal with terminally ill patients know that many would not choose to prolong their lives if some reasonable quality of life could not also be maintained. While some previous studies have evaluated the effect of the drug zidovudine (previously called AZT) on the survival of AIDS patients, researchers have now attempted to use these scales to evaluate the quality of life which can be maintained, as well. The distinction is critical, since zidovudine is known to have serious side effects. The extension of life at a significant cost of quality is of little value. Likewise, some other drug that does not prolong life, but raises its quality dramatically may be overlooked by studies that focus on survival as the only outcome measure. The present study, which included 32 patients with AIDS or serious ARC (AIDS-related complex), demonstrated a significantly longer survival among the patients taking zidovudine than those taking a placebo only. Perhaps more importantly, the patients taking zidovudine were able to sustain higher performance and quality of life scores than the patients taking placebo by the end of the study. However, at one-year follow-up, a significant difference in quality of life between the two groups was not apparent. The six surviving placebo-treated patients had a higher quality of life than did the 11 zidovudine patients. However, it is not known if this is an effect of the zidovudine or a 'hardy survivor' effect in which the placebo-survivors were intrinsically hardier individuals who were more likely to maintain a high quality of life. Further studies involving less severely ill patients may be necessary to resolve this question. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Measurement, Quality of life, AIDS (Disease), Health status indicators, Zidovudine, AIDS-related complex

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Prophylaxis against disseminated Mycobacterium avium complex with weekly azithromycin, daily rifabutin, or both

Article Abstract:

The antibiotic azithromycin appears to be more effective than rifabutin in preventing Mycobacterium avium complex infection in AIDS patients. Of 693 AIDS patients, 236 took rifabutin every day, 233 took azithromycin once a week and 224 took both drugs. Weekly azithromycin reduced the incidence of the opportunistic infection by half. The two-drug combination reduced the incidence by approximately 70% but caused more side effects. Azithromycin can be given once a week because it has a long half-life in the body.

Anti-infective agents, Mycobacterium avium complex, Mycobacterial infections, Azithromycin, Mycobacterium infections

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