When getting infected with HIV, It attaches itself to the CD-4 molecule allowing the virus to enter invading the healthy the cells, depleting the CD-4 count as a result. Thus a drop in CD-4 count would suggest an increase in HIV levels.
How AZT works?
AZT a nucleotide analog reverse-transcriptase inhibitor which works by, inhibiting the action of , the that HIV uses to make a copy of its . Reverse transcription is necessary for production of the viral double-stranded , which is subsequently integrated into the genetic material of the infected (where it is called a . (2. Wikipedia)
A study quoted ‘’Using two antiretroviral reduced progression to AIDS or death by 40% against one antiretroviral.’’ (6. BMJ 2002).This is reliable because the information obtained has been critically evaluated before published.
Figure 2 shows us how the Drug AZT inhibits the replication of the virus.
Here is a picture briefly outlining how AZT works.
Figure 2 (See reference number 4)
Research Statistics on HIV.
In a study published by Ann C. Collier et al (1990), looking at the effect of AZT treatment in HIV patients, they were able to demonstrate that high doses of AZT led to significant improvements in the mean CD-4 count. This study was conducted using patients which already had AIDs related illnesses and antibody positive HIV. This study had characteristic groups based on the doses on AZT. In all the three groups, there was an observed increase in the CD-4 count. The study included a total of 28, 24 and 15 patients getting different doses in the corresponding groups, high medium and low. The CD-4 counts were done in laboratories where they were quality-controlled procedures. Quoting the findings from the study, they found that, 70% of the subjects taking a low dose of AZT had an increase of more than 25 CD-4 lymphocytes per cubic millimeter after 4 weeks. As did, 44% taking a much higher dose following 62% taking the highest dose. These results were replicated when the counts were repeated after 24 weeks of treatment. The implication of the study was that, the prolonged stabilization of the CD-4 count could be achieved by, long-term administration of AZT. Therefore with raised levels of Cd-4 count there is prolonged time for the HIV to replicate.
Here is a diagram showing the results.
Graph showing the mean changes in CD-4 count when getting treated with AZT.
Figure 3 (NEJM)
Figure 3 shows the mean changes in CD-4 lymphocyte count after 12 and 24 weeks. As compared with base line, according to treatment groups
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High dosage of AZT – using 3 or more drugs.
Low dosage – only using AZT at low dose.
Medium-dosage – only using AZT at normal dose.
This long bar represents the standard error of the mean doses of Azt.
The number in brackets represents the number of people in the cohort study.
To what extent did AZT treat HIV ?
These results showed to an extent; taking high dosages of AZT with other combined drugs increased the CD-4 count and this in turn slowed down the replication of HIV & AIDS.
Evaluation of the Study.
Overall, this is not a good study as the sample size is not large enough giving a good representation of the population. Although they repeated the treatment after 24 weeks they should have made the period of evaluation a lot less short, to monitor the patients. In addition other external factors were not taken into account, which could have been reflected in the results they observed, e.g. diets. They did not mention if they included patients from different ethnic backgrounds, and did not have a placebo trial to see if any psychological effect had an effect on CD-4 count. By not having patients from different ethnic backgrounds and having a large sample size, the validity of the experiment was defeated. It did not give a true insight to whether it worked for different types of people as some ethnic backgrounds are more susceptible to HIV& AIDS.
Implications of HIV.
One social implications of HIV is, an increased risk of acquiring the infection.
According to research by Avert, an international HIV & AIDS charity.“Over 230,000 African Americans have died of - nearly 40 percent of total deaths - and of them more than 1 million people living with in the United States of America.”( 1. Avert 2011).
However In 1998, US Centre’s for disease control and prevention declared, “African Americans accounted for half of all AIDS cases identified in females in the US. Also with risk cases of HIV, 1 in 16 for black males, and 1 in 30 for black females, Had a far higher risk than for white males (1 in 104) and white females (1 in 588)” ( 1. Avert 2011).
This source is reliable because, it has been published by scientists who have researched into the matter of HIV/AIDS and critically analyzed patterns and trends.
Another implication of taking AZT is that there is a possibility of developing resistance to the drug, when used over a very long period of time. Taking pills or tablets on a regular basis for a very long period of time may be a problem for some people. This therefore raises issues of compliance.
In situations where the cost of AZT has been taken into account, some countries would have to make a choice as to which group of HIV positive individuals should receive the drug. Choices may have to be to be made to give HIV positive patients that may have the symptoms or have CD4 count levels, which are decreasing or have started to decrease.
Table 1: Antiretroviral Drug Costs (US$) at Market Prices.
( See reference 7-)
AZT is shown to be relatively low per unit cost, quite high per monthly cost and in the annual cost very high. This is a good source of information because it was quoted from the BMJ medical journal, which is critically assessed before being published.
Advantages of using AZT.
According to a web source they mentioned, “In patients with symptomatic HIV disease, for whom a beneficial effect is measured in months, AZT appears to slow disease progression and prolong life.” This statement re-address’ that If high levels of cd-4 are present when using AZT there is an opportunity for HIV to be treated and slowed down.
According to aids.about.com (see reference 9), other advantages of using AZT is that,
- AZT is associated with decreased risk of HIV transmission in the CDC case-control study of occupational HIV infection.
- It is a safe regimen for pregnant women.
Can be given as a single tablet of Combivir twice.
Disadvantages of using AZT.
AZT Is associated with a number of side effects such as: vomiting, headaches sleep distribution, loss of appetite, easy bruising and distribution of body fat.
One major side effects are Neutropenia where the white cell count would be low if HIV progress on without using AZT or an antiretroviral drug. This in time may increase the individual’s susceptibility to infection. Therefore raising the issue of whether AZT should be given to individuals who do not have any symptoms. It can also be argued that although there are a number of side effects associated with the drug AZT, the risks due to the drugs side effects would probably be outweighed by the potential benefits of raising the CD-4 count, which in turn would reduce the likely hood of the patient’s progression into Aids. This would slow down the opportunistic virus of AIDS progression and treat the HIV. Some may still argue that with the mild effects of AZT such sleep distribution the disadvantage would be bad when taking it, as other side effects like insomnia could arise.
Other Alternative Treatments for HIV/AIDS.
and Chinese herbal medications has become one of the most commonly used alternative therapies for AIDS. Its use has become so widely accepted that two Clinics in San Francisco have been awarded contracts through the SF Department`s Office to provide Chinese Medical treatment to people with HIV.
According to tlc.howstuffswork.com (see reference 9), “The idea behind acupuncture is that stimulating these points with acupuncture needles or pressure relieves obstructions in the flow of energy, enabling the body to heal. In the Western view, acupuncture likely works by stimulating the (the brain and spinal cord) to release chemicals called neurotransmitters and hormones. These chemicals dull pain, boost the immune system and regulate various body functions.”
Another Alternative treatment is Nutritional Therapy for AIDS.
In nutritional therapy, certain diets and nutritional supplements are used to strengthen a frail immune system. Supplements can also make up for the frequent nutrient deficiencies found in people with HIV infection and AIDS, which are often caused by chronic diarrhea and the body's reduced ability to absorb nutrients, or an eating disorder. They say with the right nutritional therapy, HIV can be prolonged and can boost your immune system, which increase CD-4 count.
Naturopathic physicians, in particular, recommend a diet with plenty of fresh and organic vegetables, beans, and whole grains, and low in sugar, animal fats, alcohol, and caffeine. Nutritional supplements, many with antioxidant properties, that can be helpful to people with HIV infection and AIDS include:
- vitamin A (beta-carotene)
- vitamin C
- vitamin B6
These alternatives have an approach to treating HIV but some may argue that it doesn’t give an immediate result in weeks like how AZT does. As AZT drastically increases the Cd-4 count reflecting a progression in combatting HIV.
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