Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, September 17, 1995                   TAG: 9509180094
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-4   EDITION: METRO 
SOURCE: The New York Times
DATELINE: WASHINGTON                                LENGTH: Medium

STUDY CHALLENGES AZT AS CHIEF DRUG FOR HIV

Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said in an interview that he planned to convene a meeting where independent experts could decide whether AZT should remain the first choice.

A large study paid for by Fauci's institute and reported last week found that AZT was less effective than another drug, didanosine, or ddI, and also less effective than combinations of AZT with either ddI or zalcitabine (ddC).

One part of the study showed that ddI lowered the rate of death from HIV infection to 5 percent from 10 percent when compared with the use of AZT alone over 147 weeks.

The study provided the first conclusive evidence that a drug could reduce the risk of death in symptomless people who are at an intermediate stage of infection with HIV, Fauci said.

Two similar independent studies are due to be completed by January. One is being conducted in the United States, the other in Europe and Australia.

Fauci said he would ask the meeting of experts to review the findings of all three studies and consider whether a change in recommendations for the treatment of HIV was needed.

Two AIDS experts who participated in the study that was reported this week, Dr. Paul Volberding of San Francisco General Hospital and Dr. Fred T. Valentine of New York University Medical Center, joined Fauci in calling the findings important.

David Barr, the director of treatment education at the Gay Men's Health Crisis in New York City, said that ``the way ddI stands out has taken everyone by surprise.''

``It suggests,'' Barr said, ``that ddI is a better single drug to start with than AZT. But it does not answer the question whether ddI is better than nothing.''

Indeed, Fauci and other experts confirmed that ddI had never been compared with a placebo in a large study, even the one now being reported, whereas AZT had proved better than a placebo in earlier studies.