A randomized study of combined zidovudine-lamivudine versus didanosine monotherapy in children with-symptomatic therapy-naive hiv-1 infection


Journal Article

Objective: The Pediatric AIDS Clinical Trials Group (PACTG) Protocol 300 assessed the clinical efficacy and safety of combination zidovudine/lamivudine (ZDV/3TC) compared with either didanosine (ddI) alone or combination ZDV/ddI. Study design: Children with symptomatic human immunodeficiency virus (HIV) infection, 6 weeks through 15 years of age, were stratified according to age and randomly assigned to receive ddI, ZDV/3TC, or ZDV/ddI. The primary endpoint was time to first progression of HIV disease or death. Enrollment in the ZDV/ddI arm stopped after 11 months on the basis of results of PACTG Protocol 162, but blinded follow-up continued. Results: For the 471 children who could be evaluated, the median age was 2.7 years, median CD4 cell count was 699 cells/mm3, and median log10 HIV RNA was 5.1/mL. Median follow-up was 9.4 months. Patients receiving ZDV/3TC had a lower risk of HIV disease progression or death than those receiving ddI alone (15 vs 38 failures, P = .0006) and a lower risk of death (3 vs 15 deaths, P = .0039). Weight and height growth rates, CD4+ cell counts, and RNA concentrations showed results favoring ZDV/3TC. For patients concurrently randomized to all 3 treatment arms, both ZDV/3TC and ZDV/ddI recipients had lower risk of HIV disease progression than those who received ddI alone (P = .0026 and P = .0045). Conclusions: Combination therapy with either ZDV/3TC or ZDV/ddI was superior, as determined by clinical and laboratory measures, to monotherapy with ddI.

Full Text

Duke Authors

Cited Authors

  • McKinney, J; Johnson, GM; Stanley, K; Yong, FH; Keller, A; O'Donnell, KJ; Brouwers, P; Mitchell, WG; Yogev, R; Wara, DW; Wiznia, A; Mofenson, L; McNamara, J; Spector, SA; Wells, B; Hodge, J; Landay, AL; Trevithick, D; Fowler, MG; Martinez, A; Martin-Carpenter, JL; Scott, J; Connaugton, E; Rutkiewicz, V; Stokes, B; Stocker, V

Published Date

  • January 1, 1998

Published In

Volume / Issue

  • 133 / 4

Start / End Page

  • 500 - 508

International Standard Serial Number (ISSN)

  • 0022-3476

Digital Object Identifier (DOI)

  • 10.1016/S0022-3476(98)70057-5

Citation Source

  • Scopus