ACTG Highlights

ddC: Identified safety and tolerance of ddC and its effects on viral/immunologic
parameters.
ddl: Identified safety and tolerance of ddl and its effects on viral/immunologic
parameters.
Completed accrual for a phase I trial of ddl in children.
d4T: Established that d4T appears to be well tolerated and has a positive effect on
CD4 cell counts and p24 antigen.
rsCD4:Demonstrated that recombinant soluble CD4 is well tolerated; efficacy has yet to
be determined.
Initiated a phase I trial of recombinant soluble CD4 in children.
MAID has also demonstrated the lack of efficacy of several drugs being widely used in the
community, providing information of great importance to physicians caring for HIV-infected
patients.
Ribavirin: Demonstrated that ribavirin fails to elicit an antiviral effect and seems to
be lymphocytotoxic, particularly at high doses.
Dextran sulfate:
Demonstrated the lack of efficacy and bioavailability of oral dextran
sulfate.
AL 721: Demonstrated no positive effect of AL 721 on p24 antigen or CD4 cell
counts even at doses higher than those used in the community.
Opportunistic Infections
The urgent need to develop new and improved treatments for the myriad opportunistic infections
that characterize AIDS and are the most frequent causes of death in AIDS patients will become
even more pressing in the 1990s as the large number of asymptomatic HIV-infected persons
progress to more advanced disease. These diseases are caused by a wide variety of viruses,
bacteria, fungi, and parasites. ACTG studies of opportunistic infections have contributed
important information that is useful to the practicing physicians who treat persons with HIV
infection. The accomplishments below are listed by disease.
Pneumocystis carinii pneumonia (PCP):
Demonstrated a slower response to aerosolized pentamidine (AP) compared with
trimethoprim/sulfamethoxazole (TMP/S) in patients with mild-moderate PCP.
Demonstrated the usefulness of a new combination, clindamycin plus oral
primaquine in mild-moderate PCP, providing the basis for a pending comparative
study of these two drugs in patients with mild "ambulatory" PCP.