Advertisement

Annals of Hematology

, Volume 69, Issue 3, pp 135–138 | Cite as

Side effects of AZT prophylaxis after occupational exposure to HIV-infected blood

  • S. H. Schmitz
  • S. Scheding
  • D. Voliotis
  • H. Rasokat
  • V. Diehl
  • M. Schrappe
Original Articles

Summary

It was the objective of this study to document and evaluate AZT-induced short-term toxicity in healthy individuals. The study was designed as a longitudinal monocentric side-effect monitoring study with prospective data collection. It was carried out at the Cologne University Hospital. The study population comprised health care workers who were taking AZT prophylaxis after accidental exposure to HIV-infected blood. Fourteen individuals were included into the study; seven of them discontinued treatment prematurely, five due to severe subjective symptoms. In case of one worker AZT had to be stopped due to severe neutropenia (800 cells /μl) with signs of upper respiratory tract infection. Four of 11 individuals taking AZT for at least 4 weeks developed neutropenia (2 WHO I, 1 WHO II, 1 WHO III). All other laboratory parameters stayed within normal range. In particular, no anemia was observed. In conclusion: Compared with other studies more neutropenias are observed. Due to side effects 50% of the workers discontinued AZT administration prematurely. The data presented herein show that AZT causes considerable side effects which must be weighed against the potential protective antiviral effect.

Key words

AZT prophylaxis Side effects Occupational exposure Neutropenia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Falciano M, Ferri F, Missori R, Massetti AP, Antilici F, Vullo V, Turbessi G (1992) The adverse effects of zidovudine on health care personnel. Int Conf Aids 8:C378 (abstract no. PoC 4813)Google Scholar
  2. 2.
    Fischl MA, Richman DD, Grieco MH, Gottlieb MS, Volberding PA, Laskin OL, Leedom JM, Groopman JE, Mildvan D, Schooley RT, Jackson GG, Durack DT, King D and the AZT collaborative working group (1987) The efficiacy of 3′-azido-3′ -desoxythymidine (azidothymidine) in the treatment of patients with AIDS and AIDS-related complex: a double-blind placebo-controlled trial. N Engl. J Med 317:185–191PubMedGoogle Scholar
  3. 3.
    Mathes LE, Polas PJ, Hayes KA, Swenson CL, Johnson S, Kociba GJ (1992) Pre- and postexposure chemoprophylaxis: evidence that 3′ -azido-3′ -deoxythymidine inhibitis feline leukemia virus disease by a drug-induced vaccine response. Antimicrob Agents Chemother 36:2715–2721PubMedGoogle Scholar
  4. 4.
    Puro V, Ippolito G, Serafin I, Guzzanti E, Serafin I, Pagano G, Suter F, Cristini G, Arici C, Angarano G, Soscia F, Vaglia A, Bonazzi L and the Italian Study Group Occupational Risk HIV Infection (1992) Zidovudine prophylaxis after accidental exposure to HIV: the Italian experience. AIDS 6:963–969PubMedGoogle Scholar
  5. 5.
    Puro V, Ippolito G, Serafin I, Guzzanti E and the Italian Study Group Occupational Risk HIV Infection (1993) Update: zidovudine postexposure prophylaxis in Italy. Int Conf AIDS 2:723 (abstract no. Po-C18-3038)Google Scholar
  6. 6.
    Richman DD, Fischl MA, Grieco MH, Gottlieb MS, Volberding PA, Laskin OL, Leedom JM, Groopman JE, Mildvan D, Hirsch MS, Jackson GG, Durack DT, Phil D, Nusinoff-Lehrmann S and the AZT collaborative working group (1987) The toxicity of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. N Engl J Med 317:192–197PubMedGoogle Scholar
  7. 7.
    Ruprecht RM, O'Brien LG, Rossoni LD, Nusinoff-Lehrmann S (1986) Suppression of mouse viraemia and retroviral disease by 3′-azido-3′-deoxythymidine (letter). Nature 323:467–469PubMedGoogle Scholar
  8. 8.
    Scadden DT, Zon LI, Groopman JE (1989) Pathophysiology and management of HIV-associated hematological disorders. Blood 74:1455–1463PubMedGoogle Scholar
  9. 9.
    Shih CC, Kaneshima H, Rabin L, Namikawa R, Sager P, McGowan J, McCune JM (1991) Postexposure prophylaxis with zidovudine suppresses human immunodeficiency virus type-1 infection in SCID-hu mice in a time-dependant manner. J Infect Dis 163:625–627PubMedGoogle Scholar
  10. 10.
    Tavares L, Roneker C, Johnston K, Nusinoff-Lehrman S, Noronha F (1987) 3′-Azido-3′-deoxythymidine in feline leukemia virus-infected cats: a model for therapy and prophylaxis of AIDS. Cancer Res 47:3190–3194PubMedGoogle Scholar
  11. 11.
    Tokars JI, Marcus R, Culver DH, Schable CA, McKibben PS, Bandea CI, Bell DA the CDC Cooperative Needlestick Surveillance Group (1993) Surveillance of HIV infection and zidovudine use among health care workers after occupational exposure to HIV-infected blood. Ann Intern Med 118:913–919PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • S. H. Schmitz
    • 1
  • S. Scheding
    • 1
  • D. Voliotis
    • 1
  • H. Rasokat
    • 2
  • V. Diehl
    • 1
  • M. Schrappe
    • 1
  1. 1.Clinic I of Internal MedicineUniversity of CologneCologneGermany
  2. 2.Department of DermatologyUniversity of CologneCologneGermany

Personalised recommendations