Inclusion Criteria
Concurrent Medication:
Allowed for Hematologic toxicity:
- Erythropoietin.
- Colony-Stimulating Factors.
- Allowed for prophylaxis of Pneumocystis carinii pneumonia (PCP):
- Aerosolized pentamidine.
- Trimethoprim/sulfamethoxazole.
- Dapsone.
- NOTE:
- If intravenous pentamidine is required for treatment of PCP, study drug should be suspended until one week after completion of intravenous pentamidine.
- Allowed:
- Prophylactic or suppressive therapy begun prior to study entry with the exception of neurotoxic agents (as defined in the protocol).
Concurrent Treatment:
Allowed:
- Transfusions for hematologic toxicity.
Exclusion Criteria
Co-existing Condition:
Patients with the following conditions or symptoms are excluded:
- Active acute AIDS defining infection.
- Clinical evidence of acute pancreatitis in the last two years or chronic pancreatitis.
- Dementia of such severity that patient cannot give informed consent.
- Grade 2 or worse peripheral neuropathy as defined by Targeted Neuropathy Score (Schaumberg).
- Prior Cytomegalovirus disease requiring ongoing systemic ganciclovir therapy.
- Extensive Kaposi's sarcoma or other malignancy requiring systemic cytotoxic myelosuppressive or neurotoxic chemotherapy.
- Cardiomyopathy or the need for antiarrhythmic therapy.
- Inability to tolerate at least 600 mg per day of zidovudine (AZT).
- Seizures within the last 6 months or the need for anticonvulsant therapy.
Concurrent Medication:
Excluded:
- Ganciclovir (DHPG).
- Myelosuppressive or neurotoxic chemotherapy.
- Antiarrhythmic therapy.
- Anticonvulsant therapy.
- Neurotoxic agents (as defined in the protocol).
- NOTE:
- If intravenous pentamidine is required for treatment of Pneumocystis carinii pneumonia (PCP), study drug should be suspended until 1 week after completion of intravenous pentamidine.
Patients with the following are excluded:
- Symptoms and conditions defined in the Patient Exclusion Co-Existing Conditions field.
- Average of two sequential CD4 counts from SciCor Clinical Laboratories in the 30 days prior to study entry > 300 cells/mm3.
Prior Medication:
Excluded, participation in studies using:
- Dideoxyinosine (ddI).
- 2',3'-Dideoxy-2',3'-didehydrothymidine (d4T).
- Dideoxycytidine (ddC).
- Excluded within one month of study entry:
- Any other experimental antiretroviral compounds.
Patients must:
- Have documented HIV positivity via ELISA.
- Meet CDC criteria for AIDS or AIDS related complex (ARC).
- Have received zidovudine (AZT) for = or > 6 months and tolerated a dose of at least 500 mg per day without significant hematologic toxicity.
- Have no acute AIDS defining opportunistic infection, but may be receiving suppressive therapy for such infections.
- Demonstrate at least one of the following criteria for clinical deterioration despite AZT therapy within 4 weeks prior to study entry (8 weeks prior for weight loss):
- involuntary weight loss of more than 5 percent of the body weight occurring over the 8 week period prior to study entry, Karnofsky score = or > 50 but demonstrating a fall = or > 20 from previous level of functioning (assessment must be persistent on two occasions at least 14 days apart), unexplained fever of = or > 38 degrees C (despite evaluation defined in protocol) for more than 7 days, appearance of newly diagnosed oral hairy leukoplakia or oral candidiasis, or recurrence of a previously quiescent multidermatomal varicella-zoster, appearance of dermatologic afflictions (e.g. psoriasis, molluscum contagiosum, or newly diagnosed seborrheic dermatitis), appearance of chronic herpetic ulcers not responsive to acyclovir therapy.
Required:
- Zidovudine (AZT) for = or > 6 months prior to study entry.