Summary
Zidovudine therapy seems to be effective for reducing vertical transmission of HIV infection and preventing paediatric AIDS. Besides those cases in which it is indicated, zidovudine plays an important role in safeguarding maternal well-being. Even though no data indicating teratogenic effect of this drug exist, its use during the first trimester should be limited to those cases where it is absolutely indicated. All undergoing this therapy should be informed that no information regarding the long term effects of this drug are available yet. Further controlled studies are necessary if this drug is tobe used in those cases where it could actually be of benefit.
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References
Mitsuya H, Weinhold K, Furman P, et al. 3′-azido-3′-deoxythymidine (BW A509U): an antiviral agent that inhibits the infectivity and cytopathic effect of human T-lymphotropic virus type III/lymphadenopathy-associated virus in vitro. Proc Natl Acad Sci USA 1985; 82: 7096
Yarchoan R, Klecker RW, Weinhold KJ, et al. Administration of 3′-azido-3′-deoxythymidine, an inhibitor of HTLV III/LAV replication, to patients with AIDS or AIDS related complex. Lancet 1986; 1: 575–80
Zidovudine (AZT) [editorial]. Lancet 1987; 1: 957-8
Chaisson RE, Allain JP, Leuther M, et al. Significant changes in HIV antigen level in the serum of patients treated with azidothymidine. N Engl J Med 1986; 315: 1610–11
Fischl MA, Richman DD, Grieco MH, et al. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex: a double-blind, placebo-controlled trial. N Engl J Med 1987; 317: 185–91
Volberding PA, Lagakos SW, Koch MA, et al. Zidovudine in asymptomatic human immunodeficiency virus infection: a controlled trial in persons with fewer than 500 CD4-positive cells per cubic millimeter. N Engl J Med 1990; 322: 941–9
Yarchoan R, Broder S. In Broder S, editor. AIDS: modern concepts and therapeutic challenges. New York: Marcel Dekker, 1987: 335–60
Hagler N, Frame PT. Azidothymidine neurotoxicity. Lancet 1986; 2: 1392
Bessen LJ, Greene JB, Louie E, et al. Severe polymyositis-like syndrome associated with zidovudine therapy of AIDS and ARC [letter]. N Engl J Med 1988; 318: 708
Food and Drug Administration. Federal Register 1980; 44: 37434-67
Toltzis P, Marx CM, Kleinman N, et al. Zidovudine-associated embryonic toxicity in mice. J Infect Dis 1991; 163: 1212–8
Toltzis P, Mourton T, Magnuson T. Effect of zidovudine on preimplantation murine embryos. Antimicrob Agents Chemother 1933; 37: 1610–13
Gogu SR, Beckman BS, Agrawal KC. Amelioration of zidovudine-induced fetal toxicity in pregnant mice. Antimicrob Agent Chemother 1992; 36: 2370–4
Ayers K. Preclinical toxicology of zidovudine. Am J Med 1988; 85: 186
Stahlmann R, Rahn U, Baumann-Wilschke T, et al. Pharmacokinetics, prenatal toxicity and hematotoxicity of zidovudine in rats. Naunyn-Schmiedebergs Arch Pharmacol 1989; 339 Suppl.: R 30
Stahlmann R, Chahoud I, Bochert G, et al. Prenatal toxicity of zidovudine in rats [abstract]. Teratology 1988; 38: 28
Greene JA, Ayers KR, De Miranda P, et al. Postnatal survival in Wistar rats following oral dosage with zidovudine on gestational day 10. Fundam Appl Toxicol 1990; 15: 201–6
Physicians’ Desk Reference. 45th ed. Oradell (NJ): Medical Economics, 1991
National Institute of Allergy and Infectious Disease. Expert panel clears AZT neonate trials after reviewing data on carcinogenicity. AIDS Research Exchange. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, National Institutes of Health, 1990 Summer: 1-3
Viscarello RR, De Gennaro NJ, Hobbins JC. Preliminary experience with the use of zidovudine (AZT) during pregnancy. Society of Perinatal Obstetricians Abstracts. Am J Obstet Gynecol 1991; 164: 248
Taylor U, Bardeguez A. Antiretroviral therapy during pregnancy and postpartum. Society of Perinatal Obstetricians Abstracts. Am J Obstet Gynecol 1992; 166: 390
Delke I, Greenhaw J, Sanchez-Ramos L, et al. Antiretroviral therapy during pregnancy. Society of Perinatal Obstetricians Abstracts. Am J Obstet Gynecol 1993; 168: 424
Sperling RS, Stratton P, O’Sullivan MJ, et al. A survey of zidovudine use in pregnant women with human immunodeficiency virus infection. N Engl J Med 1992; 326: 857–61
Connor EM, Rhoda SP, Gelber R, et al. For the Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med 1994; 331: 1173–80
O’Sullivan MJ, Boyer PJ, Scott GB, et al. The pharmacokinetics and safety of zidovudine in the third trimester of pregnancy for women infected with human immunodeficiency virus and their infants: phase I Acquired Immunodeficiency Syndrome Clinical Trials Group Study (protocol 082). Am J Obstet Gynecol 1993; 168: 1510–6
Little BB, Bawdon RE, Christmas JT, et al. Pharmacokinetics of azidothymidine during late pregnancy in Long-Evans rats. Am J Obstet Gynecol 1989; 161: 732–4
Hankins GD, Lowery CL, Scott RT, et al. Transplacental transfer of zidovudine in near term pregnant baboon. Am J Obstet Gynecol 1990; 163: 728–32
Schenker S, Raymond FJ, King TS, et al. Azidothymidine (zidovudine) transport by the human placenta. Am J Med Sci 1990; 299(1): 16–20
Chavanet P, Diquet B, Waldner A, et al. Perinatal pharmacokinetics of zidovudine. N Engl J Med 1989; 321: 1548–9
Liebes L, Mendoza S, Lee JD, et al. Further observation on zidovudine transfer and metabolism by human placenta. AIDS 1993; 7: 590–2
Lyman WD, Tanaka KE, Kress Y, et al. Zidovudine concentrations in human fetal tissue: implications for perinatal AIDS. Lancet 1990; 335: 1280–1
Sperling RS, Stratton P. Treatment options for human immunodeficiency virus-infected pregnant women. Obstet Gynecol 1992; 79: 443–8
CDC: zidovudine for the prevention of HIV transmission from mother to infant._MMWR Morb Mortal Wkly Rep 1994; 43: 286-7
CDC recommendations of the US Public Health Service Task Force on the use of zidovudine to reduce perinatal transmission of human immunodeficiency virus. MMWR Morb Mortal Wkly Rep 1994; 43: RR-11
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De Santis, M., Noia, G., Caruso, A. et al. Guidelines for the Use of Zidovudine in Pregnant Women with HIV Infection. Drugs 50, 43–47 (1995). https://doi.org/10.2165/00003495-199550010-00004
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DOI: https://doi.org/10.2165/00003495-199550010-00004