Revision as of 00:47, 9 January 2008 editEye.earth (talk | contribs)397 edits →Martinez reference: Comments re MastCell.← Previous edit | Latest revision as of 00:02, 21 March 2024 edit undoAnomieBOT (talk | contribs)Bots6,557,045 edits Adding/updating {{OnThisDay}} for 2024-03-20. Errors? User:AnomieBOT/shutoff/OnThisDayTagger | ||
(295 intermediate revisions by 59 users not shown) | |||
Line 1: | Line 1: | ||
{{ |
{{Talk header}} | ||
{{ |
{{Not a forum|] propaganda}} | ||
{{On this day | |||
{{WikiProject Pharmacology|class=B|importance=high}} | |||
|date1=2005-03-20|oldid1=16334946|date2=2006-03-20|oldid2=44685029|date3=2007-03-20|oldid3=116352688|date4=2008-03-20|oldid4=199514738|date5=2009-03-20|oldid5=278368801|date6=2010-03-20|oldid6=350726984|date7=2011-03-20|oldid7=419834018|date8=2013-03-20|oldid8=545679215|date9=2016-03-20|oldid9=711009807|date10=2018-03-20|oldid10=831200191|date11=2020-03-20|oldid11=946428133|date12=2021-03-20|oldid12=1012897895|date13=2024-03-20|oldid13=1214437808}} | |||
{{WikiProject banner shell|class=B|vital=yes|1= | |||
{{WikiProject AIDS |importance=Top }} | |||
{{WikiProject Pharmacology |importance=High }} | |||
{{WikiProject Viruses |importance=High }} | |||
{{WikiProject Medicine |importance=Mid }} | |||
}} | |||
<!-- B-class criteria ]: | |||
1. The article is suitably referenced, with inline citations. | |||
2. The article reasonably covers the topic, and does not contain obvious omissions or inaccuracies. | |||
3. The article has a defined structure. | |||
4. The article is reasonably well-written. | |||
5. The article contains supporting materials where appropriate. | |||
6. The article presents its content in an appropriately understandable way. | |||
--> | |||
{{Reliable sources for medical articles}} | |||
==Wiki Education Foundation-supported course assignment== | |||
'''Attention''': I'm a bit confused about the following paragraph in the article: | |||
] This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available ]. Student editor(s): ], ], ], ]. Peer reviewers: ], ], ], ]. | |||
"When used as a preventative treatment, AZT has proven to be particularly effective. If treatment is started before the total amount of virus, known as the viral load, reaches a critical point of 50 million parts per millilitre of blood serum, the chance of AIDS developing is effectively zero. This is widely used with medical practitioners who receive accidental infections." | |||
{{small|Above undated message substituted from ] by ] (]) 05:29, 18 January 2022 (UTC)}} | |||
Aren't two things being confused here? I'm not a doctor, but from what I've heard, antivirals given shortly after exposure (preferably within a few hours) to HIV virus can decrease the risk of becoming infected by about 80%. If succesful, the person would test negative on HIV tests. This treatment type is known as PEP. However, the article talks about treatment starting af 80 million copies/mL and claims this will decrease risk of getting full-blown AIDS to 0%. 80 million copies/mL seems like a fairly high number so I doubt that it can be PEP the paragraph is referring to (additionally, PEP doesn't decrease the risk to 0%). Rather, it seems the article is talking about the possibility that therapy initiation in the first weeks/months after infection (ususally when symptoms of acute HIV develops) will lower the viral set-point and improve long-term prognosis even after treatment is stopped (in this scenario the patient would still test positive on HIV tests). However, from what I've read, this is currently being researched and there's no solid evidence of this. So how could the risk be practically 0% as the paragraph claims? The best we can say that it delays onset by, say, 15 years because that is the longset people receiving early treatment has lived until now. | |||
==Mode of Action== | |||
''AIDS was actually considerably more widespread in Africa'' is rather presumptive. The criteria for labelling a case "AIDS" are much weaker (broader) in Africa than they are in North America. And it was not suggested AZT was ''the'' cause of AIDS, but ''a'' cause, under the substance-abuse rubric. Malnutrition and starvation -- long a problem in Africa, worse after "First World" and IMF resource stripping -- can also resemble the AID syndrome, and doubtless compound the effects of pollutants. -- ] | |||
Should we be making it clear in the article that the mechanism behind AZT’s stated affinity for HIV's reverse-transcription enzyme is cell division -- that AZT has no affinity for any kind of non-dividing cell, HIV-infected or not? ] (]) 16:35, 16 December 2010 (UTC) | |||
:AZT doesn't have an affinity for ''cells''. It has an affinity for various forms of ], a family of enzymes essential in DNA replication, which in turn is a necessary step in cell division. Unlike bacteria, viruses cannot replicate on their own, so they are dependent upon cellular DNA replication machinery to reproduce and spread. Many modern antivirals act at the level of DNA polymerase.<p>I'm not sure I see that we need to emphasize this aspect ''here'' when this is an issue common to many antiviral medicines. It creates the impression that AZT is somehow unique in this regard, which is misleading and false. Do you think we need to belabor this point on, say, ], ], ], and ]? Or is there something unique about AZT in your view? ''']''' <sup>]</sup> 17:42, 16 December 2010 (UTC) | |||
::I don't see an issue with it (phrased as MastCell explains), particularly if the words "Like all/most antiviral medications..." but there needs to be a source for it. It's a reasonable and interesting part of the mechanism that needs to be contextualized within the family of antiviral drugs. ] <small>] ] Misplaced Pages's rules:</small>]/] 18:14, 16 December 2010 (UTC) | |||
Do they actually still prescribe this poison? I thought the 1993 Concorde study -- one of the only ones not funded by the manufacturers -- put an end to it when it showed AZT had a statistically higher death rate than placebo. ] 03:46, 27 Jul 2004 (UTC) | |||
:Yes, it's still being used, but nowadays usually not as monotherapy, and in smaller doses than in the Concorde study. The main finding of the Concorde study was, that they could find no benefit in taking the drug ''before'' the symptoms appear, ie. the progression ''to'' advanced disease wasn't affected. | |||
I wouldn't call the difference in death rate (176/171) statistically higher (bad luck?). After all that was just one study, there are others that contradict. Here's a couple of sites on AZT safety: , and . ] 18:22, Jul 27, 2004 (UTC) | |||
:::This might be a useful review article. ] (]) 19:20, 16 December 2010 (UTC) | |||
In accordance with ] naming policy, I propose we move this page to the ] ]. If you have any concern with this proposal, please discuss it on ]. ] 18:09, 23 Dec 2004 (UTC) | |||
So the mechanism enabling AZT, ], ], ], and ] is cell division alone, not the presence of a drug's viral target inside a cell. And the absence of that viral target will not prevent each drug from terminating DNA/RNA synthesis during cellular replication. Is this correct? ] (]) 22:43, 16 December 2010 (UTC) | |||
==Patent issues section== | |||
That the ] book is cited in this article at all is reason enough to question its accuracy. First of all, the lawsuit to which the section presumably refers may have been aided by Public Citizen, but the actual title was ''Burroughs Wellcome Co. v. Barr Labs., Inc.,''. Secondly, the line about the taxpayer footing the entire bill for the drug development is ''probably'' nonsense -- I assume that BW paid for the clinical trials (which are another massively expensive part of drug development) and the chemical engineering needed to scale up production (yet another oft-overlooked part). Since the case isn't online, I'll have to check back before changing anything. But it is cited in a few opinions that are online: search for 'AZT' to find one. ] (]) 06:45, 26 Mar 2005 (UTC) | |||
:No. ] (]) 23:25, 16 December 2010 (UTC) | |||
== Hungarian word "azt" == | |||
::Bruce, if you need some general education about virology and antiviral pharmacology, then you should ask at the ], read some of the articles that have been suggested here, or check out a few college-level textbooks. If you're just ''feigning'' ignorance to post ridiculous "gotcha" questions, then please don't waste everyone's time. Either way, you're in the wrong venue. ''']''' <sup>]</sup> 05:28, 17 December 2010 (UTC) | |||
Here are two studies dated 1995 and 2000 respectively. ; . | |||
I cut this recent anonymous addition from the article, as it seems unlikely that an English-language encyclopedia would need an entry on the Hungarian word for "that": | |||
:'''Azt''' also means 'that' in Hungarian. | |||
If an Englsh-language entry is desired for that word, it may be better to put it at ] instead. There is no entry in for it, though, and I don't speak Hungarian, so I'll let someone else write ] and ] if they're important. ] 21:21, 9 January 2006 (UTC) | |||
And now consider this sentence, taken from the Modes of Action section of the article: | |||
== Martinez reference == | |||
''The triphosphate form also inhibits DNA polymerase used by human cells to undergo cell division, but has approximately 100-fold greater affinity for viral reverse transcriptase.'''' Because of this selectivity, ''in vitro'' studies have shown that AZT inhibits HIV replication without affecting the function of normal T cells.''''' | |||
I've cut the reference to by M. Martinez. You can dispute anything you want if you cite ''Medical Hypotheses'', which is . In any case the article is out of date. ] 19:52, 5 April 2006 (UTC) | |||
The two footnotes are from 1986 and 1985, respectively. I move that the above statement be amended as follows: | |||
:Just a quick reply I don't want to get into a debate. Medical Hypotheses isn't peer reviewed, but there are occassionally some good articles there. This particular citation is a good paper, and still valid despite being several years old. The article discusses the genetics of mutation and drug resistance as it relates to nucleoside analogs. These genetics don't change through the years, so still valid. The article points out a lack of laboratory evidence for drug resistance by nucleoside analog drugs. For example, lack of correlation between reverse transcriptase activity and drug resistance. Keep in mind the standard AIDS articles from the peer reviewed journals from the 1980s are still cited.] 15 June 2006 | |||
''Early studies '''' indicated that ''in vitro'' the triphosphate form of AZT inhibited DNA polymerase used by human cells to undergo cell division, but had approximately 100-fold greater affinity for viral reverse transcriptase; and that because of that affinity AZT inhibited HIV replication without affecting the function of normal T cells. Later ''in vitro'' studies '''' indicate that AZT's cytotoxic interaction with cellular metabolism both ''in vitro'' and ''in vivo'' may be more complex and powerful than previously thought.'' | |||
::I'm afraid I don't have access to the full text of the article, but the abstract claims that, "laboratory techniques which test for viral sensitivity to the drugs fail to provide direct evidence for the existence of ." More recent studies of appear to contradict this claim. ] 18:54, 15 June 2006 (UTC) | |||
Comments, anyone? ] (]) 05:10, 18 December 2010 (UTC) | |||
:::Yeah but putting the cart before the horse isn't good science and puts into doubt the original theory. In other words, claiming HIV develops drug resistance, then providing the evidence years later ... ] | |||
:The papers discuss the mechanisms by which AZT suppresses bone marrow function and causes anemia. You seem to want to juxtapose with information about AZT's binding affinity and the function of mature T cells. Thus, your proposed text is vague and misleading. So no. As an aside, this will probably be the last time I address efforts to cherry-pick the medical literature and misrepresent this subject; see ]. ''']''' <sup>]</sup> 05:16, 19 December 2010 (UTC) | |||
::::What matters here is the current state of knowledge, not when that knowledge was acquired. is abundant. ] 19:29, 15 June 2006 (UTC) | |||
The full text of the two papers in question is and . ] (]) 07:35, 19 December 2010 (UTC) | |||
::Those are ], so are inappropriate. ] <small>] ] Misplaced Pages's rules:</small>]/] 01:54, 20 December 2010 (UTC) | |||
{{Collapse top|The Internet contains many forums for the discussion of ] on HIV/AIDS. This is ].}} | |||
Does anyone have a bottle of AZT? I have read on a wiki talk page that AZT's included pamphlet gives a list of warnings - one of which is AIDS like symptoms. Worth a picture or link or confirmation. Duesberg may already have this on his site - funny how long it takes anyone to bother to read one of those warning blurbs.] 19:45, 25 May 2007 (UTC) | |||
They are definitely primary. Primary sources are to be used with care as they are subject to abuse, and it is a violation to base articles on primary sources. (I have commented on primary sources on my ] and ] pages.) WLU has deleted the two primary sources I recently placed (they are and ). I have no problem with that, provided certain other primary sources in the article are deleted as well. I have identified the following as primary sources and nominate them for deletion : | |||
. | |||
After giving the above refs a look, read ]'s remarks regarding them, made in the second paragraph of the ] section of my Talk page. I have excerpted those remarks below: | |||
''The article contains many, many sources (28 as of my reading), the sources are reliable and third-party, and there are very vew primary sources used in the page. Those few that are used are appropriately used - primary sources are permitted if not misused. The statements they source are quite basic, they are accurate, they report the scientific consensus that AZT is a useful and safe (relative to dying from AIDS) treatment for HIV infection, and present no synthesis. Consensus for the statement was established on talk:Zidovudine in July of this year. The fact that you think AZT causes more harm than HIV is irrelevant, the scientific community agrees it is an extremely useful treatment for HIV infection to prevent AIDS.'' | |||
My understanding - maybe incorrect but in the literature as they say - is that AZT is known to harm/kill the immune system. How could you tell if it was AZT or HIV or if HIV was just around for the ride? Taking a drug that kills your immune system sounds like a chaser when you are already drunk(ie not likely to help much).] 20:00, 25 May 2007 (UTC) | |||
Note especially two of WLU's assertions: | |||
:Read the Misplaced Pages articles on ] and follow some of the source links there. Short answer - AZT doesn't cause AIDS. ''']''' <sup>]</sup> 19:12, 26 May 2007 (UTC) | |||
''. .. '''' report the scientific consensus . . . '' | |||
::That's a rather deceptive response considering that the definition of AIDS includes a "positive result on an HIV antibody test". Pneumonia + HIV negative = Pneumonia. Pneumonia + HIV positive = AIDS. A more useful question would be, to what degree do the unwanted side effects of AZT mirror the symptoms of AIDS? ] 18:21, 5 November 2007 (UTC) | |||
and | |||
'' . . . the scientific community agrees . . . ''. | |||
My understanding from the "reappraisal" article and others is that AZT was a shot in the dark that doesn't seem to cure AIDS either. It seems that destroying the immune system would have little benefit to someone with a weaken immune system - but then Duesberg seems to rely on logic. Is AZT still used or has it been replace/supplanted?] 11:20, 29 May 2007 (UTC) | |||
Now look over again the two primary sources he deleted. They are and . Note certain terms in the titles, such as ''inhibits'', ''potently inhibits'' ''dramatically alters'', and ''clinically relevant concentrations.'' Are such terms the reason WLU feels that the papers are unacceptable as primary sources, as opposed to the other primary sources long in place? Does he feel that the papers actually ''support'' AZT's use as treatment but is afraid their titles will mislead lay readers? Or is WLU's generalization about the scientific consensus regarding the safety and efficacy of AZT simply an inaccurate one? ] (]) 19:43, 20 December 2010 (UTC) | |||
:Read the Misplaced Pages articles on ] and ], specifically the section on treatment. ''']''' <sup>]</sup> 19:26, 29 May 2007 (UTC) | |||
:It's not the source that's problematic, it's how it is used. Those two sources were used to represent strong general risks due to specific mechanisms based on primary sources. For that you would need a secondary source. The first source, Horowitz, is the first documentation of AZT being synthesized and the text is accompanied by two other sources. That would be an acceptable use of a primary source in my mind, in particular because no interpretation is needed. The second source is Horowitz again. The third similarly reports only the results of the primary source with no interpretation. Same with the fourth. And the fifth. And the sixth and seventh. | |||
:Yep, you're wasting our time. If you can't tell the difference between an obviously appropriately used primary source that is not used to present a conclusion that bucks the scientific consensus and one that's cherry-picked towards a slanted agenda, there's not much point in continuing the conversation. ] <small>] ] Misplaced Pages's rules:</small>]/] 21:05, 20 December 2010 (UTC) | |||
::Numbered the links; they're not permalinks so any changes to the references in the main page will break about three quarters of them. is the version I believe is being worked from. ] <small>] ] Misplaced Pages's rules:</small>]/] 22:59, 20 December 2010 (UTC) | |||
Real name editors! Are you willing to let your supervisors, colleagues, co-workers, family, and friends view your thoughts on this dispute? Maybe some of those people would care to weigh in with ''their'' real names too? | |||
Interesting articles - it used to be too deadly but all they had. Now they give a smaller dose combined with other stuff ( all made by Glaxco it seemed ). They mentioned using vitamis and mineral supplements and small dose of poison - sounds like homeopathy ( very similar to the witnesses that were not allowed to testify in the S African AIDS trial - Andre Pan*** ). ] 16:31, 30 May 2007 (UTC) | |||
So let's start at the beginning with my original question: ''Should we be making it clear in the article that the mechanism behind AZT’s stated affinity for HIV's reverse-transcription enzyme is cell division -- that AZT has no affinity for any kind of non-dividing cell, HIV-infected or not?'' A pseudonym answered that AZT, a thymidine analog, has no affinity for cells at all. Meanwhile the article states that AZT penetrates cell walls by diffusion. What isn't stated clearly is that once inside, AZT's sole originally-designed chemotherapeutic purpose is to destroy the cell during replication, regardless of what kind of cell it is and certainly whether or not it contains reverse transcriptase. My concern is that casual readers may go away with a vague impression that AZT somehow targets HIV specifically and not dividing cells in general -- in other words, that it shares HIV's stated affinity for T-cells. ] (]) 23:10, 20 December 2010 (UTC) | |||
:::Wow, what a spectacular waste of time. There are certainly some primary sources referred to in Bruce's above post. There are also numerous non-primary sources, perhaps a third. I've looked over the uses of the primary sources and found none that were used inappropriately. They reference the type of basic information that primary sources are useful for (raw numbers, initial studies, large and early clinical trials, unsurprising results that are corroborated by later studies and were not contradicted by later evidence). I didn't find any that were outright inappropriately used, though some could be supplemented by reference to secondary sources. In many cases they were. So, I think we're done, it's ]. | |||
:::Yeah, Bruce, allow me to yet again point out that your call for "real name" is just a red herring and really just underscores your ability to substantiate your postings with anything remotely close to an appropriate use of a reference or policy. If you want to edit under your real name, I suggest ], where you will doubtless find a hostile reception. | |||
:::Oh, and your point "''What isn't stated clearly is that once inside, AZT's sole originally-designed chemotherapeutic purpose is to destroy the cell during replication, regardless of what kind of cell it is and certainly whether or not it contains reverse transcriptase''" is pretty stupid considering the reason it failed to be used as a chemotherapeutic agent is because it was wildly, wildly unsuccessful at destroying body cells during replication. That's why it's toxicity is quite low - it tends to interfere with viral and mitochondrial ability to replicate, not the ] cells that comprise much of the human body. Also, your concern is that people might go away with the impression that AZT is safer than dying of AIDS. ] <small>] ] Misplaced Pages's rules:</small>]/] 23:21, 20 December 2010 (UTC) | |||
No one told you to re-number the references. You chose to waste your own time there. | |||
Besides the AIDS warning in the included pamphlet there also seems to be a skull and crossbones on the outside label - not a reassuring symbol on a medicine bottle.] 16:33, 30 May 2007 (UTC) | |||
I'm curious about your statement that AZT "tends to interfere with viral and mitochondrial ability to replicate, not the eukaryotic cells that comprise much of the human body." ] (]) 02:30, 21 December 2010 (UTC) | |||
:This is because AZT has an FDA "black box" label. If my understanding is correct, a "black box" label is given to a drug if it has caused permanent damage or death during regular use. I think this information should be included in the article. ] 18:21, 5 November 2007 (UTC) | |||
:Given your ignorance of basic biology, I'm not surprised. ] <small>] ] Misplaced Pages's rules:</small>]/] 04:15, 21 December 2010 (UTC) | |||
Readers? ] (]) 23:40, 21 December 2010 (UTC) | |||
::Not exactly. A "black box warning" (more accurately, a boxed warning) is used by the FDA , including to highlight potentially serious or important side effects, to draw attention to important monitoring requirements, or to communicate any information deemed of great importance to a prescriber. A fairly large number of widely used medications carry black box warnings (for example, the anticoagulant ]). Given the level of, to put it kindly, uninformed commentary (for instance, there is no skull and crossbones on ''any'' package insert in the US, much less on that of AZT), I'd prefer that we're very scrupulous about how we present a boxed warning and what context we give. ''']''' <sup>]</sup> 22:20, 5 November 2007 (UTC) | |||
Why link ''idiosyncratic views'' to ] in the above green banner? Shouldn't it go ? And shouldn't the phrase ''HIV/AIDS'' read ''basic biology''? ] (]) 03:19, 27 December 2010 (UTC) | |||
:::Thank you for the information. According to the site you listed, a black box warning is issued when one of the following happens: * There is an adverse reaction so serious in proportion to the potential benefit from the drug (e.g., a fatal, life-threatening or permanently disabling adverse reaction) that it is essential that it be considered in assessing the risks and benefits of using a drug OR * There is a serious adverse reaction that can be prevented or reduced in frequency or severity by appropriate use of the drug (e.g., patient selection, careful monitoring, avoiding certain concomitant therapy, addition of another drug or managing patients in a specific manner, avoiding use in a specific clinical situation) OR * FDA approved the drug with restrictions to assure safe use because FDA concluded that the drug can be safely used only if distribution or use is restricted (e.g., under 21 CFR part 314, subpart H, § 314.520 “Approval with restrictions to assure safe use”). In the case of AZT, which of the three listed reasons caused it to be given a black box warning? I think this information should be included in the article, ESPECIALLY if it is the first of the three cases (namely, "a fatal, life-threatening or permanently disabling adverse reaction"). I also reject your "helpful correction" with the sanitized "boxed warning" term considering that both black box warning and black box label are commonly-used terms to warn against the demonstrated harm done by regular usage of prescription drugs. ] (]) 22:54, 20 November 2007 (UTC) | |||
:''Your views'' are the idiosyncratic ones. Please stop pushing this fringe views here. Several editors appear to be invoking ], which is advisable here. ] and move on. ] (]) 03:40, 27 December 2010 (UTC) | |||
Oh, you do the same, ] -- er -- I mean, ] of course. ] (]) 16:08, 27 December 2010 (UTC) | |||
::::The side effects of AZT are covered in this article. If you feel they should be covered differently, then please propose alternate wording with appropriate ]. My point above (beyond a relatively pedantic one about proper terminology) was that you seem to placing quite a bit of weight on the boxed warning; in fact, many commonly used medications bear boxed warnings and are used effectively with a good risk/benefit ratio. Rather than saying "OMG it has a black box!" we should be accurately and neutrally presenting what's known about this medication's side effects. ''']''' <sup>]</sup> 23:05, 20 November 2007 (UTC) | |||
{{Collapse bottom}} | |||
== repeated addition of primary reference addressing one mutation == | |||
Regarding MastCell’s statement above that “there is no skull and crossbones on ''any'' package insert in the US, much less on that of AZT”, follow this link: | |||
This is an issue of ] and ], in my opinion, and I'd appreciate other viewpoints. One or two new users ({{user|62.203.111.94}}, {{user|62.202.82.168}}, both geolocating to Zurich fwiw) have added the same paragraph twice, citing a single primary reference (also from Zurich), addressing compensatory mutations. Secondary references already cited address the concept of interactions among mutations. My sense is that this is a new editor, and I'm hoping that discussion here will help. Hard to use their user talk page when the IP address is changing. -- ] (]) 01:01, 5 April 2011 (UTC) | |||
http://images.google.com/images?hl=en&q=AZT+label&gbv=2 | |||
:Sorry guys, I am one of those contributors. I am just a student and discussed this in class. I am relatively new if it comes to discussing HIV resistance mutations. I was not aware of the fact that I added it twice. Still, I thought it might be interesting to expand the viral resistance paragraph a bit. But if the original editors believe that the interactions among mutations are already discussed sufficiently then deleting it was certainly OK. <span style="font-size: smaller;" class="autosigned">—Preceding ] comment added by ] (]) 15:37, 5 April 2011 (UTC)</span><!-- Template:UnsignedIP --> <!--Autosigned by SineBot--> | |||
Loundry: you needn't "propose alternate wording" to MastCell nor anyone else. Misplaced Pages encourages bold editing. | |||
] 21:44, 3 December 2007 (UTC) | |||
::Yes. Misplaced Pages ''also'' encourages the insertion only of information ] in a ] (though that's more often overlooked than ]). Google image searches are not a reliable source. ''']''' <sup>]</sup> 16:54, 4 December 2007 (UTC) | |||
:Erm—excuse me, but that's a label of ''research-grade'' AZT (apparently from ]). It is not a package insert, and it is not a drug label. The toxicity described on the label (blood and bone marrow, i.e. ]) is indeed a side effect of AZT, and is mentioned in the article. ]<small> (]·])</small> 22:20, 3 December 2007 (UTC) | |||
::Erm-exucse me, you IDIOT, the AMOUNT of AZT in the ''research-grade'' AZT container is LESS than that prescribed in medication dosages. How can "X" amount of "research grade" AZT warrant a cross bones label, when 25 times the "X" amount in prescription is just a "package insert"??? ] 04:44, 4 December 2007 (UTC) | |||
:::Calm down, take a deep breath, and try to ] (you'll be taken more seriously). The issue is, of course, not the relative ''amounts'' of the drug. Research-grade chemicals are not intended for human use and have not met the rigorous standards expected of pharmaceutical formulations. I feel fairly confident, from my days in the lab, that if you found a bottle of research-grade ethanol it would have a skull and crossbones on it. Yet the bottle of Tanqueray in my liquor cabinet doesn't have a skull and crossbones. Again, ''no'' pharmaceutical product is labeled with a skull and crossbones, citing Google images is hardly going to convince anyone of your correctness, and the whole skull-and-crossbones thing is an AIDS-denialist canard which thrives on misinformation. ''']''' <sup>]</sup> 16:52, 4 December 2007 (UTC) | |||
::::MastCell, how is "research-grade" AZT any different in chemical composition from "pharmaceutical" AZT?? Both are chemically and physically identical. AZT must be synthesized in the laboratory, it is not a naturally occurring substance. If I held one bottle of "research-grade" AZT in one hand, one bottle of the same amount of "pharmaceutical" AZT in the other, then mixed them up behind my back and asked you to tell which was which, how would you tell?? YOU CAN'T. Your canard about research-grade chemicals not being "intended for human use" because they have not "met the rigorous standards expected of pharmaceutical formulations" leaves me flabbergasted. If you read the research-grade AZT label, the reasons justifying the toxicity claims are spelled in plain English, and they have absolutely nothing to do with "rigorous standards expected of pharmaceutical formulations" they have to do with the direct biochemical consequences of ingesting AZT. And yes, the issue *IS* the relative amounts of the drugs. Water is toxic at a high enough dosage. So, there is no way to tell "research-grade" AZT from "pharmaceutical" AZT, they are chemically indistinguishable, the research label has a skull and crossbones, advising you to seek "medical help" if you happen to ingest the ENTIRE bottle's contents, yet if you are an HIV patient and happen to ingest 10 times that amount each and every day of your life, for the rest of your life, you are not in NEED of "medical help" you are FOLLOWING "medical help". Black is white. Left is right. Up is down. Unbelievable. ] (]) 00:46, 5 December 2007 (UTC) | |||
::No worries - clearly you write well, and I hope you'll start editing wikipedia regularly. If you create an account, there are ]. Please don't hesitate to leave a note on ] if you have any questions. -- ] (]) 21:57, 5 April 2011 (UTC) | |||
:::::I'm not very interested in continuing this argument. You do understand the idea of a risk-benefit ratio? That ], for instance, is "poisonous" - it makes you vomit and lose your hair, it can easily kill you, and if it's lying around a laboratory in a bottle it should ''definitely'' have a skull and crossbones on it? But that if you have testicular cancer, it will save your life if used judiciously? These are not particularly sophisticated concepts. ''']''' <sup>]</sup> 01:39, 5 December 2007 (UTC) | |||
Scray, I have an account since quite awhile. I reviewed my entry and discussed it with others. The entries on Zivovudine are kind of outdated and we need to introduce new findings. You are standing a bit in the way. Viral resistance is not even addressed from a molecular biological point of view. We need mechanisms and genomic data not just information that is long known. These mutations are very relevant in HIV/AIDS treatment. It is terrible to encounter such bias just based on the fact that it came from here. I ask you not to delete it. Or do you like just deleting stuff, that's vandalism, Scray!. ] (]) 07:34, 6 April 2011 (UTC) Scray, you are a computer scientist or a molecular biologist, or both? Impressive your activities, still though, I don't know why you were deleting it. Undue weight? Cheeze, this was an article in the Journal of Infectious diseases, and I don't see where else this resistance is discussed. I ask you to reinstate my entry. ] (]) 07:43, 6 April 2011 (UTC) | |||
:We need to be able to discuss matters without resorting to personal insults. Please refer to ] and refrain from accusations of vandalism and bias. We are tasked here with writing a general encyclopaedia, not reviewing this month's scientific findings and certainly not reviewing single primary sources from our labs or something we read in class. Although there are of course exceptions, such as for high-profile subjects with massive media coverage, we should use ] for articles like this one and summarise the sources in language accessible to the general population. We have a long way to go in this regard, but granting an entire paragraph to one primary source is ], and using amino acid mutation notations without explanation is unhelpful to our readers. | |||
:I encourage you to update the article using secondary sources on resistance. ] (]) 14:34, 6 April 2011 (UTC) | |||
==Dispute Tags== | |||
Readers: notice that MastCell: | |||
I'm opening up a dispute as to factual accuracy, neutrality, and the conclusions drawn from the sources used in this article. This article does not meet Misplaced Pages standards. It needs a rewrite. <span style="font-size: smaller;" class="autosigned">— Preceding ] comment added by ] (]) 05:32, 1 April 2012 (UTC)</span><!-- Template:Unsigned IP --> <!--Autosigned by SineBot--> | |||
:Well you haven't really opened up a dispute, because you haven't explained your concerns in a way that's specific enough to be actionable. Before you do so, you may wish to read Misplaced Pages's ], as well as our article on ] and the FAQ at the top of ]. ]<sup>(]•])</sup> 06:48, 1 April 2012 (UTC) | |||
*For starters, how about this sentence from the article: "AZT has been certified as non-carcinogenic, non-mutagenic and non-clastogenic in humans." <span style="font-size: smaller;" class="autosigned">— Preceding ] comment added by ] (]) 18:21, 1 April 2012 (UTC)</span><!-- Template:Unsigned IP --> <!--Autosigned by SineBot--> | |||
1) failed to explain why Google images are inherently different from any other images that appear in Misplaced Pages; | |||
*Another one: "The selectivity has been proven to be due to the cell's ability to quickly repair its own DNA chain if it is broken by AZT during its formation, whereas the HIV virus lacks that ability." <span style="font-size: smaller;" class="autosigned">— Preceding ] comment added by ] (]) 03:27, 2 April 2012 (UTC)</span><!-- Template:Unsigned IP --> <!--Autosigned by SineBot--> | |||
2) implied they are unsuitable even for the discussion page; | |||
*There is a conflict between the number of primary sources in the article and the following comment, above the light-blue message-box, by editor WLU: ''Those are primary sources, so are inappropriate.'' Are primary sources to be permitted or not? We can't say they are inappropriate and then openly allow them. Appropos of this point I have added the Primary Sources template-message at the top of the article. | |||
3) concluded from them that “ . . . ''no'' pharmaceutical product is labeled with a skull and crossbones” ! | |||
:::I'm not sure it's appropriate to say that AZT has been "certified as non-carcinogenic". At the same time, we need to make an effort to be honest and scrupulous about describing the clinical impact of AZT on cancer. In people with HIV/AIDS, AZT-based antiretroviral therapy appears to clearly ''reduce'' the incidence of many cancers (most dramatically, that of Kaposi sarcoma; see for example {{PMID|17565153}}, {{PMID|11078759}}, {{PMID|15770006}}).<p>I'm not clear on your second objection. The sentence is perhaps oversimplified but arguably reasonably accurate.<p>As to primary sources, it's important to understand the ]. Primary sources are not categorically forbidden; however, they need to be used carefully, to ''illustrate'' the current state of knowledge rather than to rebut or undermine expert opinion. ''']''' <sup>]</sup> 18:26, 3 April 2012 (UTC) | |||
Regarding AZT, it's listed , which deserves a place in the article. | |||
4) advised one commenter to "Calm down, take a deep breath, and try to avoid personal attacks (you'll be taken more seriously)." | |||
I'm curious about your observation of AZT as reducing Kaposi's. Wouldn't that action be a form of chemotherapy, which was AZT’s original intended purpose? Yet the article states that AZT isn't related to chemotherapy, and is supported by a reference that makes no such claim. Ditto the foonotes , , and , appended to the statements I quote, above. The references don't support. And thus the tag-warning I placed. Want to restore it now? ] (]) 02:35, 4 April 2012 (UTC) | |||
5) then wrote: “the whole skull-and-crossbones thing is an AIDS-denialist canard which thrives on misinformation.” | |||
:No, I'd like to actually discuss the question on the talk page and try to resolve it. I'm old-fashioned that way.<p>The history of AZT as cancer chemotherapy is largely of interest to historians of the HIV/AIDS epidemic and to AIDS denialists, but OK, I'll bite. AZT was tested as a cancer chemotherapeutic, but was never particularly effective against any type of cancer (hence its abandonment). The doses used to treat HIV/AIDS would have zero effect against a sarcoma. And non-AZT-containing HAART regimens similarly decrease the risk of Kaposi sarcoma. The common thread is immunodeficiency; if you treat the immunodeficiency with HAART, then people don't get Kaposi sarcoma. ''']''' <sup>]</sup> 03:50, 4 April 2012 (UTC) | |||
] (]) |
Does the common thread also include the lack of AZT in HAART? ] (]) 06:23, 6 April 2012 (UTC) | ||
:I'm not sure what you mean. AZT has been in continual use in HIV/AIDS since its introduction in the late 1980s, and remains a component of many HAART regimens. Could you elaborate? ''']''' <sup>]</sup> 17:02, 6 April 2012 (UTC) | |||
Your own comment, above: ''And non-AZT-containing HAART regimens similarly decrease the risk of Kaposi sarcoma.'' ] (]) 18:55, 6 April 2012 (UTC) | |||
:I'm sorry, I thought I was being clear. The upshot is that AZT, as used in modern clinical practice to treat HIV/AIDS, does ''not'' seem to be associated with an increased risk of cancer (if anything, the opposite; it can help ''reduce'' the risk of many cancers). Therefore, it's misleading at best to describe it as a "carcinogen" in isolation, because that leaves the reader with the incorrect inference that using AZT will increase their risk of developing cancer. ''']''' <sup>]</sup> 19:06, 6 April 2012 (UTC) | |||
AZT is carcinogen in animals and a suspect carcinogen in humans according to IARC.(http://www.inchem.org/documents/iarc/vol76/zidovudine.html)"There is inadequate evidence in humans for the carcinogenicity of zidovudine. There is sufficient evidence in experimental animals for the carcinogenicity of zidovudine.Overall evaluation Zidovudine is possibly carcinogenic to humans (Group 2B)". | |||
in my opinion ,the article is too much favourable to AZT and hide (voluntarily or not) the real facts (AZT does not cure AIDS and is not free of dangerous side effects) ] (]) 14:30, 30 July 2012 (UTC) | |||
:This issue has been discussed at length. I think any responsible treatment of the carcinogenicity of AZT would need to acknowledge that it is ''not'' associated with any increased risk of cancer in HIV/AIDS patients, and in fact may ''decrease'' the risk of some cancers. It doesn't make a lot of sense to me to highlight test-tube carcinogenicity while ignoring the huge volume of ''clinical'' data on the subject. ''']''' <sup>]</sup> 16:43, 30 July 2012 (UTC) | |||
== Comment on safety of AZT in lead == | |||
I think should be reverted, but I've already reverted a similar one once and I'll wait a bit to see if others comment. An article from the LA Times (not a ]) from 22 years ago (doubly disqualifying this as a ]) is not adequate support for a claim such as this. This is exacerbated by the use of the present tense. In addition, we shouldn't pack the ] with references; rather, the article body should have the content and references, and the lead paragraph should summarize. -- ] (]) 20:24, 8 December 2012 (UTC) | |||
::Your point is taken about references in the lead. The LA Times ref can be currently found as footnote 23, so that ref could be removed form the lead. As for the other reference, it merely repeats what is generally available at any number of websites, so that ref could be removed as well. As for your objection to the LA Times as a medical reference, I think you miss the point. There is no question that the story reported the facts correctly. And the program reported is still in place -- have you heard of any plan afoot to stop giving pregnant women and children AZT as a preventative measure? The only difference today is that AZT is often used on combination with other drugs to make a cocktail, all of which is reported in the article. Also, there are lots of other sources in this article that are about that old. ] (]) 20:52, 8 December 2012 (UTC) | |||
:::{{ec}} Regardless of age or reliability, none of the three sources supports "one of the most safe and effective drugs in medical history" at all. I've reverted to maintain ]. ]<sup>(]•])</sup> 20:55, 8 December 2012 (UTC) | |||
:::Doesn't a program have to be safe to be effective? What use is a drug that kills its patients, or is worse than the disease? Adrian, are you saying that the administration of AZT to children and pregnant women as a preventative is unsafe, given the alternative of certain death from AIDS for anyone testing positive or likely to test positive to the virus and not treated with antiretrovirals? How could they ''not'' be safe in that context? Nobody is saying that they are as safe as aspirin. Also, this trade-off is discussed in the article. Can't figure out what the objection is. AZT is very safe today, as are all antiretrovirals. , usage of these drugs is going to be increasing throughout the third world's children and pregnant women. We should recognize and acknowledge this, not hide it. | |||
:::Barring any further objection, I will revert the latest change so as to include "safe and effective", etc. ] (]) 21:21, 8 December 2012 (UTC) | |||
::::Before my reversion, the lead read " is recognized by the Centers for Disease Control as one of the most safe<sup>]</sup> and effective<sup>]</sup> drugs in medical history.<sup>]</sup>" None of the cited sources mentions the Centers for Disease Control; none claims AZT is one of the most safe drugs in medical history; none claims AZT is one of the most effective drugs in medical history. My objection was that the sources did not support the statement cited. Please see ]. ]<sup>(]•])</sup> 23:47, 8 December 2012 (UTC) | |||
:::OK, I've gone ahead and deleted the unsupported statements in the lead. <small><span class="autosigned">— Preceding ] comment added by ] (] • ]) 01:24, 9 December 2012 (UTC)</span></small><!-- Template:Unsigned --> <!--Autosigned by SineBot--> | |||
== confusing sentence/inconsistent paragraph == | |||
New to this, so sorry if this isn't quite how it's done.<br /> | |||
I found this sentence confusing. "Consistent and proactive precautionary measures, such as the rigorous use of antiretroviral medications, cesarean section, face masks, heavy-duty rubber gloves, clinically segregated disposable diapers, and avoidance of mouth contact will further reduce child-attendant transmission of HIV to as little as 1–2%" <br /> | |||
It's under the HIV prophylaxis section. <br /> | |||
The paragraph talks about mother-child transmission. But the last sentence I believe is talking about child-mother transmission (one of the sources it cites is a blog that has a paper abstract about transmission to the mother through breastfeeding. I'm not sure why a BLOG is cited instead of the actual article). Also, one of the sources is a broken link. This is a bit confusing because the third citation is actually about mother to child transmission... <br /> | |||
Admittedly, I couldn't get access to the paper that the abstract was for, but I couldn't find any mention in any of the 3 sources of "heavy duty rubber gloves" or "face masks" and I don't really know what "mouth contact" means, because I'm pretty sure that just swapping saliva isn't supposed to be a means of transmission for HIV. (Actually, I think it's referring to infant-mother transmission through breastfeeding, but this is not really "mouth contact"). <br/> | |||
*edit*<br> | |||
also, the next paragraph talks about "parental and infant" deaths, which again seems to be referencing infant-mother transmission. But the article cited says nothing about this. The article talks about the effects AZT has had on people in general and on mother-infant transmission specifically. But nothing about parents specifically. | |||
] (]) 05:55, 21 February 2014 (UTC) | |||
== Plans to improve page == | |||
Hi there, | |||
I'm part of a group of 4 pharmacy students at UCSF. We are planning on making slight edits to this page to improve content and readability. Here is a brief description of some of the changes we plan on making. | |||
*Simplification of medical jargon, especially under adverse effects and pharmacokinetic properties. | |||
*Review and update older sources from the 80s/90s. | |||
*Correct grammatical issues such as run-on sentences, particularly under "HIV Treatment" and "HIV Prevention". | |||
*Add sources for claims without a source. | |||
*The Viral Resistance section is simply a repeat of what was stated in the HIV Treatment section. | |||
*Mechanism of action is missing a citation. | |||
*Perhaps the page could benefit from splitting the discussion about AZT's toxicity to our own cells and specificity to HIV into two separate paragraphs. | |||
*Maintain objective tone throughout the entire page. | |||
*Society and Culture: The drug was featured heavily in the Matthew McConaughey movie, Dallas Buyers Club. | |||
*History: The short paragraph regarding 6MP may not be necessary/relevant. Also, there's a sentence explaining what reverse transcriptase is even though it is already linked and explained earlier. | |||
*Address other issues brought up in the talk page, specifically the suggested edit in 2014 under "confusing sentence/inconsistent paragraph". | |||
] (]) 18:18, 4 November 2016 (UTC) | |||
:That all seems great. Please make sure you use ] sources for all ] and ] for the rest. Not too excited about the movie thin; there is no end to that sort of thing and it generally becomes a magnet for low quality additions. ] (]) 20:18, 4 November 2016 (UTC) | |||
== Student Review #3 == | |||
Upon review, the overall structure of the edits is consistent with Misplaced Pages's manual of style for medicine-related articles. The introduction is succinct and gives a great overview of the medication while not getting too specific in terms of topics that follow in later sections. The flow of introduction --> Medical Uses --> Side effects --> Mechanism --> Chemistry --> History is logical with respect to formatting. The only recommendations that I have are to change the title of" Side Effects" to "Adverse Effects" and "Mechanism" to "Mechanism of Action" to keep heading format consistent across medication-related wikipedia articles. | |||
] (]) 02:57, 15 November 2016 (UTC) | |||
:whether the structure is "logical" to you is irrelevant. The structure complies with ] and the lead complies with ]. You and the other students need to read ], ], and the other policies and guidelines and base your review on them, and '''only''' on them. We do not capitalize headers that way per the general manual of style, ]. ] (]) 03:20, 15 November 2016 (UTC) | |||
Does the draft submission reflect a neutral point of view? If not, specify… | |||
The group submission did not reflect any personal opinions and points of view about the drug, Zidovudine. Everything was written in the format of using the drug name or "it". They did not use "I", "we", "my" or "our" in their edits. They also did not encourage or discourage the use of the drug. They simply discussed a simple background, medical uses, side effects and mechanism of action. At the end of the article, a law suite against the drug was discussed but it did not take sides in the discussion. Instead they presented the argument from each party. <!-- Template:Unsigned --><small class="autosigned">— Preceding ] comment added by ] (] • ]) 20:11, 15 November 2016 (UTC)</small> <!--Autosigned by SineBot--> | |||
== Student #2 == | |||
STUDENT 2 – Are the points included verifiable with cited secondary sources that are freely accessible? If not, specify… | |||
Yes majority of points included are verifiable with cited secondary sources that are freely accessible. Source #61 was a broken link and source #56 is not "freely accessible." Overall, the group utilized many reputable sources that are in fact freely accessible when editing the Zidovudine page. <!-- Template:Unsigned --><small class="autosigned">— Preceding ] comment added by ] (] • ]) 20:30, 15 November 2016 (UTC)</small> <!--Autosigned by SineBot--> | |||
:Removing a source because it is behind a paywall violates Misplaced Pages '''policy'''. See ]. If you can find a ref that is as good or better (say a more recent review) that is free that is great and you can replace a paywalled article with that, but never reduce source quality or leave something unsourced due to the free/not free criterion. The most important thing is high-quality sourcing and content summarizing those sources accurately. ] (]) 10:53, 17 November 2016 (UTC) | |||
== Cultural history of AZT == | |||
This article could do with a lot of work on the cultural history of AZT during the early part of the AIDS crisis, as well as more detail on its efficacy as a monotherapy (as it was used through the 1980s) and the amount of research into it that went on under ]'s leadership of ], to the exclusion of other therapies. | |||
Hopefully someone can beat me to it, but ]'s book '']'' would be a good place to start and the could be useful (] was strongly opposed to the initial — overdosed and toxic — use of AZT monotherapy in the 1980s, which was later shown to be of minimal therapeutic value); I would expect that ]'s '']'' might also have useful information. I recently did a load of work on the biography of early AIDS activist ] and some of the ] I used there might also be helpful. — <span class="vcard"><span class="fn">]</span> <small>(])</small></span> 14:04, 13 January 2017 (UTC) | |||
Agreed. The article currently reads like an advertisement.] (]) 03:34, 12 October 2017 (UTC) | |||
==1987== | |||
These two refs | |||
https://books.google.ca/books?id=zNCJmuWgHAoC&pg=PA179#v=onepage&q&f=false | |||
https://www.drugs.com/monograph/zidovudine.html | |||
support the date as 1987 plus it being the first and are better than an old NYTs article which only supports part of it. ] (] · ] · ]) 20:16, 11 February 2019 (UTC) |
Latest revision as of 00:02, 21 March 2024
This is the talk page for discussing improvements to the Zidovudine article. This is not a forum for general discussion of the article's subject. |
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
Archives: 1, 2, 3 |
This page is not a forum for general discussion about AIDS-denialist propaganda. Any such comments may be removed or refactored. Please limit discussion to improvement of this article. You may wish to ask factual questions about AIDS-denialist propaganda at the Reference desk. |
A fact from this article was featured on Misplaced Pages's Main Page in the On this day section on 13 dates. March 20, 2005, March 20, 2006, March 20, 2007, March 20, 2008, March 20, 2009, March 20, 2010, March 20, 2011, March 20, 2013, March 20, 2016, March 20, 2018, March 20, 2020, March 20, 2021, and March 20, 2024 |
This level-5 vital article is rated B-class on Misplaced Pages's content assessment scale. It is of interest to the following WikiProjects: | |||||||||||||||||||||||||||||||||||||||||
|
Ideal sources for Misplaced Pages's health content are defined in the guideline Misplaced Pages:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Zidovudine.
|
Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Jborbon, Iaminwillmart, Rahatm786, Stevenwsamuels. Peer reviewers: Lissy5821, Ceb333, Elmira.Z, Mkw 09.
Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 05:29, 18 January 2022 (UTC)
Mode of Action
Should we be making it clear in the article that the mechanism behind AZT’s stated affinity for HIV's reverse-transcription enzyme is cell division -- that AZT has no affinity for any kind of non-dividing cell, HIV-infected or not? BruceSwanson (talk) 16:35, 16 December 2010 (UTC)
- AZT doesn't have an affinity for cells. It has an affinity for various forms of DNA polymerase, a family of enzymes essential in DNA replication, which in turn is a necessary step in cell division. Unlike bacteria, viruses cannot replicate on their own, so they are dependent upon cellular DNA replication machinery to reproduce and spread. Many modern antivirals act at the level of DNA polymerase.
I'm not sure I see that we need to emphasize this aspect here when this is an issue common to many antiviral medicines. It creates the impression that AZT is somehow unique in this regard, which is misleading and false. Do you think we need to belabor this point on, say, acyclovir, cidofovir, ganciclovir, and ribavirin? Or is there something unique about AZT in your view? MastCell 17:42, 16 December 2010 (UTC)
- I don't see an issue with it (phrased as MastCell explains), particularly if the words "Like all/most antiviral medications..." but there needs to be a source for it. It's a reasonable and interesting part of the mechanism that needs to be contextualized within the family of antiviral drugs. WLU (t) (c) Misplaced Pages's rules:/complex 18:14, 16 December 2010 (UTC)
- This might be a useful review article. Graham Colm (talk) 19:20, 16 December 2010 (UTC)
So the mechanism enabling AZT, acyclovir, cidofovir, ganciclovir, and ribavirin is cell division alone, not the presence of a drug's viral target inside a cell. And the absence of that viral target will not prevent each drug from terminating DNA/RNA synthesis during cellular replication. Is this correct? BruceSwanson (talk) 22:43, 16 December 2010 (UTC)
- No. Graham Colm (talk) 23:25, 16 December 2010 (UTC)
- Bruce, if you need some general education about virology and antiviral pharmacology, then you should ask at the reference desk, read some of the articles that have been suggested here, or check out a few college-level textbooks. If you're just feigning ignorance to post ridiculous "gotcha" questions, then please don't waste everyone's time. Either way, you're in the wrong venue. MastCell 05:28, 17 December 2010 (UTC)
Here are two studies dated 1995 and 2000 respectively. 1; 2.
And now consider this sentence, taken from the Modes of Action section of the article:
The triphosphate form also inhibits DNA polymerase used by human cells to undergo cell division, but has approximately 100-fold greater affinity for viral reverse transcriptase. Because of this selectivity, in vitro studies have shown that AZT inhibits HIV replication without affecting the function of normal T cells.
The two footnotes are from 1986 and 1985, respectively. I move that the above statement be amended as follows:
Early studies indicated that in vitro the triphosphate form of AZT inhibited DNA polymerase used by human cells to undergo cell division, but had approximately 100-fold greater affinity for viral reverse transcriptase; and that because of that affinity AZT inhibited HIV replication without affecting the function of normal T cells. Later in vitro studies indicate that AZT's cytotoxic interaction with cellular metabolism both in vitro and in vivo may be more complex and powerful than previously thought.
Comments, anyone? BruceSwanson (talk) 05:10, 18 December 2010 (UTC)
- The papers discuss the mechanisms by which AZT suppresses bone marrow function and causes anemia. You seem to want to juxtapose with information about AZT's binding affinity and the function of mature T cells. Thus, your proposed text is vague and misleading. So no. As an aside, this will probably be the last time I address efforts to cherry-pick the medical literature and misrepresent this subject; see WP:SHUN. MastCell 05:16, 19 December 2010 (UTC)
The full text of the two papers in question is here and here. BruceSwanson (talk) 07:35, 19 December 2010 (UTC)
- Those are primary sources, so are inappropriate. WLU (t) (c) Misplaced Pages's rules:/complex 01:54, 20 December 2010 (UTC)
The Internet contains many forums for the discussion of idiosyncratic views on HIV/AIDS. This is not one of them. |
---|
They are definitely primary. Primary sources are to be used with care as they are subject to abuse, and it is a violation to base articles on primary sources. (I have commented on primary sources on my user and talk pages.) WLU has deleted the two primary sources I recently placed (they are here and here). I have no problem with that, provided certain other primary sources in the article are deleted as well. I have identified the following as primary sources and nominate them for deletion : 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20. After giving the above refs a look, read WLU's remarks regarding them, made in the second paragraph of the Templates section of my Talk page. I have excerpted those remarks below: The article contains many, many sources (28 as of my reading), the sources are reliable and third-party, and there are very vew primary sources used in the page. Those few that are used are appropriately used - primary sources are permitted if not misused. The statements they source are quite basic, they are accurate, they report the scientific consensus that AZT is a useful and safe (relative to dying from AIDS) treatment for HIV infection, and present no synthesis. Consensus for the statement was established on talk:Zidovudine in July of this year. The fact that you think AZT causes more harm than HIV is irrelevant, the scientific community agrees it is an extremely useful treatment for HIV infection to prevent AIDS. Note especially two of WLU's assertions: . .. report the scientific consensus . . . and . . . the scientific community agrees . . . . Now look over again the two primary sources he deleted. They are here and here. Note certain terms in the titles, such as inhibits, potently inhibits dramatically alters, and clinically relevant concentrations. Are such terms the reason WLU feels that the papers are unacceptable as primary sources, as opposed to the other primary sources long in place? Does he feel that the papers actually support AZT's use as treatment but is afraid their titles will mislead lay readers? Or is WLU's generalization about the scientific consensus regarding the safety and efficacy of AZT simply an inaccurate one? BruceSwanson (talk) 19:43, 20 December 2010 (UTC)
Real name editors! Are you willing to let your supervisors, colleagues, co-workers, family, and friends view your thoughts on this dispute? Maybe some of those people would care to weigh in with their real names too? So let's start at the beginning with my original question: Should we be making it clear in the article that the mechanism behind AZT’s stated affinity for HIV's reverse-transcription enzyme is cell division -- that AZT has no affinity for any kind of non-dividing cell, HIV-infected or not? A pseudonym answered that AZT, a thymidine analog, has no affinity for cells at all. Meanwhile the article states that AZT penetrates cell walls by diffusion. What isn't stated clearly is that once inside, AZT's sole originally-designed chemotherapeutic purpose is to destroy the cell during replication, regardless of what kind of cell it is and certainly whether or not it contains reverse transcriptase. My concern is that casual readers may go away with a vague impression that AZT somehow targets HIV specifically and not dividing cells in general -- in other words, that it shares HIV's stated affinity for T-cells. BruceSwanson (talk) 23:10, 20 December 2010 (UTC)
No one told you to re-number the references. You chose to waste your own time there. I'm curious about your statement that AZT "tends to interfere with viral and mitochondrial ability to replicate, not the eukaryotic cells that comprise much of the human body." BruceSwanson (talk) 02:30, 21 December 2010 (UTC)
Readers? BruceSwanson (talk) 23:40, 21 December 2010 (UTC) Why link idiosyncratic views to AIDS denialism in the above green banner? Shouldn't it go here? And shouldn't the phrase HIV/AIDS read basic biology? BruceSwanson (talk) 03:19, 27 December 2010 (UTC)
Oh, you do the same, WLU -- er -- I mean, Yobol of course. BruceSwanson (talk) 16:08, 27 December 2010 (UTC) |
repeated addition of primary reference addressing one mutation
This is an issue of undue weight and reliable sourcing, in my opinion, and I'd appreciate other viewpoints. One or two new users (62.203.111.94 (talk · contribs), 62.202.82.168 (talk · contribs), both geolocating to Zurich fwiw) have added the same paragraph twice, citing a single primary reference (also from Zurich), addressing compensatory mutations. Secondary references already cited address the concept of interactions among mutations. My sense is that this is a new editor, and I'm hoping that discussion here will help. Hard to use their user talk page when the IP address is changing. -- Scray (talk) 01:01, 5 April 2011 (UTC)
- Sorry guys, I am one of those contributors. I am just a student and discussed this in class. I am relatively new if it comes to discussing HIV resistance mutations. I was not aware of the fact that I added it twice. Still, I thought it might be interesting to expand the viral resistance paragraph a bit. But if the original editors believe that the interactions among mutations are already discussed sufficiently then deleting it was certainly OK. —Preceding unsigned comment added by 83.78.162.156 (talk) 15:37, 5 April 2011 (UTC)
- No worries - clearly you write well, and I hope you'll start editing wikipedia regularly. If you create an account, there are substantial benefits. Please don't hesitate to leave a note on my Talk page if you have any questions. -- Scray (talk) 21:57, 5 April 2011 (UTC)
Scray, I have an account since quite awhile. I reviewed my entry and discussed it with others. The entries on Zivovudine are kind of outdated and we need to introduce new findings. You are standing a bit in the way. Viral resistance is not even addressed from a molecular biological point of view. We need mechanisms and genomic data not just information that is long known. These mutations are very relevant in HIV/AIDS treatment. It is terrible to encounter such bias just based on the fact that it came from here. I ask you not to delete it. Or do you like just deleting stuff, that's vandalism, Scray!. Osterluzei (talk) 07:34, 6 April 2011 (UTC) Scray, you are a computer scientist or a molecular biologist, or both? Impressive your activities, still though, I don't know why you were deleting it. Undue weight? Cheeze, this was an article in the Journal of Infectious diseases, and I don't see where else this resistance is discussed. I ask you to reinstate my entry. Osterluzei (talk) 07:43, 6 April 2011 (UTC)
- We need to be able to discuss matters without resorting to personal insults. Please refer to WP:CIVIL and refrain from accusations of vandalism and bias. We are tasked here with writing a general encyclopaedia, not reviewing this month's scientific findings and certainly not reviewing single primary sources from our labs or something we read in class. Although there are of course exceptions, such as for high-profile subjects with massive media coverage, we should use secondary sources for articles like this one and summarise the sources in language accessible to the general population. We have a long way to go in this regard, but granting an entire paragraph to one primary source is undue weight, and using amino acid mutation notations without explanation is unhelpful to our readers.
- I encourage you to update the article using secondary sources on resistance. Keepcalmandcarryon (talk) 14:34, 6 April 2011 (UTC)
Dispute Tags
I'm opening up a dispute as to factual accuracy, neutrality, and the conclusions drawn from the sources used in this article. This article does not meet Misplaced Pages standards. It needs a rewrite. — Preceding unsigned comment added by 206.217.201.30 (talk) 05:32, 1 April 2012 (UTC)
- Well you haven't really opened up a dispute, because you haven't explained your concerns in a way that's specific enough to be actionable. Before you do so, you may wish to read Misplaced Pages's policy on neutrality, as well as our article on AIDS denialism and the FAQ at the top of Talk:HIV. Adrian J. Hunter 06:48, 1 April 2012 (UTC)
- For starters, how about this sentence from the article: "AZT has been certified as non-carcinogenic, non-mutagenic and non-clastogenic in humans." — Preceding unsigned comment added by 206.217.201.30 (talk) 18:21, 1 April 2012 (UTC)
- Another one: "The selectivity has been proven to be due to the cell's ability to quickly repair its own DNA chain if it is broken by AZT during its formation, whereas the HIV virus lacks that ability." — Preceding unsigned comment added by 206.217.201.30 (talk) 03:27, 2 April 2012 (UTC)
- There is a conflict between the number of primary sources in the article and the following comment, above the light-blue message-box, by editor WLU: Those are primary sources, so are inappropriate. Are primary sources to be permitted or not? We can't say they are inappropriate and then openly allow them. Appropos of this point I have added the Primary Sources template-message at the top of the article.
- I'm not sure it's appropriate to say that AZT has been "certified as non-carcinogenic". At the same time, we need to make an effort to be honest and scrupulous about describing the clinical impact of AZT on cancer. In people with HIV/AIDS, AZT-based antiretroviral therapy appears to clearly reduce the incidence of many cancers (most dramatically, that of Kaposi sarcoma; see for example PMID 17565153, PMID 11078759, PMID 15770006).
I'm not clear on your second objection. The sentence is perhaps oversimplified but arguably reasonably accurate.
As to primary sources, it's important to understand the relevant sourcing guideline. Primary sources are not categorically forbidden; however, they need to be used carefully, to illustrate the current state of knowledge rather than to rebut or undermine expert opinion. MastCell 18:26, 3 April 2012 (UTC)
- I'm not sure it's appropriate to say that AZT has been "certified as non-carcinogenic". At the same time, we need to make an effort to be honest and scrupulous about describing the clinical impact of AZT on cancer. In people with HIV/AIDS, AZT-based antiretroviral therapy appears to clearly reduce the incidence of many cancers (most dramatically, that of Kaposi sarcoma; see for example PMID 17565153, PMID 11078759, PMID 15770006).
Regarding AZT, it's listed here, which deserves a place in the article.
I'm curious about your observation of AZT as reducing Kaposi's. Wouldn't that action be a form of chemotherapy, which was AZT’s original intended purpose? Yet the article states that AZT isn't related to chemotherapy, and is supported by a reference that makes no such claim. Ditto the foonotes , , and , appended to the statements I quote, above. The references don't support. And thus the tag-warning I placed. Want to restore it now? 206.217.201.30 (talk) 02:35, 4 April 2012 (UTC)
- No, I'd like to actually discuss the question on the talk page and try to resolve it. I'm old-fashioned that way.
The history of AZT as cancer chemotherapy is largely of interest to historians of the HIV/AIDS epidemic and to AIDS denialists, but OK, I'll bite. AZT was tested as a cancer chemotherapeutic, but was never particularly effective against any type of cancer (hence its abandonment). The doses used to treat HIV/AIDS would have zero effect against a sarcoma. And non-AZT-containing HAART regimens similarly decrease the risk of Kaposi sarcoma. The common thread is immunodeficiency; if you treat the immunodeficiency with HAART, then people don't get Kaposi sarcoma. MastCell 03:50, 4 April 2012 (UTC)
Does the common thread also include the lack of AZT in HAART? 206.217.201.30 (talk) 06:23, 6 April 2012 (UTC)
- I'm not sure what you mean. AZT has been in continual use in HIV/AIDS since its introduction in the late 1980s, and remains a component of many HAART regimens. Could you elaborate? MastCell 17:02, 6 April 2012 (UTC)
Your own comment, above: And non-AZT-containing HAART regimens similarly decrease the risk of Kaposi sarcoma. 206.217.201.30 (talk) 18:55, 6 April 2012 (UTC)
- I'm sorry, I thought I was being clear. The upshot is that AZT, as used in modern clinical practice to treat HIV/AIDS, does not seem to be associated with an increased risk of cancer (if anything, the opposite; it can help reduce the risk of many cancers). Therefore, it's misleading at best to describe it as a "carcinogen" in isolation, because that leaves the reader with the incorrect inference that using AZT will increase their risk of developing cancer. MastCell 19:06, 6 April 2012 (UTC)
AZT is carcinogen in animals and a suspect carcinogen in humans according to IARC.(http://www.inchem.org/documents/iarc/vol76/zidovudine.html)"There is inadequate evidence in humans for the carcinogenicity of zidovudine. There is sufficient evidence in experimental animals for the carcinogenicity of zidovudine.Overall evaluation Zidovudine is possibly carcinogenic to humans (Group 2B)".
in my opinion ,the article is too much favourable to AZT and hide (voluntarily or not) the real facts (AZT does not cure AIDS and is not free of dangerous side effects) Ippocrate (talk) 14:30, 30 July 2012 (UTC)
- This issue has been discussed at length. I think any responsible treatment of the carcinogenicity of AZT would need to acknowledge that it is not associated with any increased risk of cancer in HIV/AIDS patients, and in fact may decrease the risk of some cancers. It doesn't make a lot of sense to me to highlight test-tube carcinogenicity while ignoring the huge volume of clinical data on the subject. MastCell 16:43, 30 July 2012 (UTC)
Comment on safety of AZT in lead
I think this edit should be reverted, but I've already reverted a similar one once and I'll wait a bit to see if others comment. An article from the LA Times (not a reliable source for medical claims) from 22 years ago (doubly disqualifying this as a reliable source) is not adequate support for a claim such as this. This is exacerbated by the use of the present tense. In addition, we shouldn't pack the lead section with references; rather, the article body should have the content and references, and the lead paragraph should summarize. -- Scray (talk) 20:24, 8 December 2012 (UTC)
- Your point is taken about references in the lead. The LA Times ref can be currently found as footnote 23, so that ref could be removed form the lead. As for the other reference, it merely repeats what is generally available at any number of websites, so that ref could be removed as well. As for your objection to the LA Times as a medical reference, I think you miss the point. There is no question that the story reported the facts correctly. And the program reported is still in place -- have you heard of any plan afoot to stop giving pregnant women and children AZT as a preventative measure? The only difference today is that AZT is often used on combination with other drugs to make a cocktail, all of which is reported in the article. Also, there are lots of other sources in this article that are about that old. TubesandBurners (talk) 20:52, 8 December 2012 (UTC)
- (edit conflict) Regardless of age or reliability, none of the three sources supports "one of the most safe and effective drugs in medical history" at all. I've reverted to maintain text-source integrity. Adrian J. Hunter 20:55, 8 December 2012 (UTC)
- Your point is taken about references in the lead. The LA Times ref can be currently found as footnote 23, so that ref could be removed form the lead. As for the other reference, it merely repeats what is generally available at any number of websites, so that ref could be removed as well. As for your objection to the LA Times as a medical reference, I think you miss the point. There is no question that the story reported the facts correctly. And the program reported is still in place -- have you heard of any plan afoot to stop giving pregnant women and children AZT as a preventative measure? The only difference today is that AZT is often used on combination with other drugs to make a cocktail, all of which is reported in the article. Also, there are lots of other sources in this article that are about that old. TubesandBurners (talk) 20:52, 8 December 2012 (UTC)
- Doesn't a program have to be safe to be effective? What use is a drug that kills its patients, or is worse than the disease? Adrian, are you saying that the administration of AZT to children and pregnant women as a preventative is unsafe, given the alternative of certain death from AIDS for anyone testing positive or likely to test positive to the virus and not treated with antiretrovirals? How could they not be safe in that context? Nobody is saying that they are as safe as aspirin. Also, this trade-off is discussed in the article. Can't figure out what the objection is. AZT is very safe today, as are all antiretrovirals. Thanks to the WHO, usage of these drugs is going to be increasing throughout the third world's children and pregnant women. We should recognize and acknowledge this, not hide it.
- Barring any further objection, I will revert the latest change so as to include "safe and effective", etc. ElziSome (talk) 21:21, 8 December 2012 (UTC)
- Before my reversion, the lead read " is recognized by the Centers for Disease Control as one of the most safe and effective drugs in medical history." None of the cited sources mentions the Centers for Disease Control; none claims AZT is one of the most safe drugs in medical history; none claims AZT is one of the most effective drugs in medical history. My objection was that the sources did not support the statement cited. Please see Misplaced Pages:Citing sources, section Text–source integrity. Adrian J. Hunter 23:47, 8 December 2012 (UTC)
- Barring any further objection, I will revert the latest change so as to include "safe and effective", etc. ElziSome (talk) 21:21, 8 December 2012 (UTC)
- OK, I've gone ahead and deleted the unsupported statements in the lead. — Preceding unsigned comment added by ElziSome (talk • contribs) 01:24, 9 December 2012 (UTC)
confusing sentence/inconsistent paragraph
New to this, so sorry if this isn't quite how it's done.
I found this sentence confusing. "Consistent and proactive precautionary measures, such as the rigorous use of antiretroviral medications, cesarean section, face masks, heavy-duty rubber gloves, clinically segregated disposable diapers, and avoidance of mouth contact will further reduce child-attendant transmission of HIV to as little as 1–2%"
It's under the HIV prophylaxis section.
The paragraph talks about mother-child transmission. But the last sentence I believe is talking about child-mother transmission (one of the sources it cites is a blog that has a paper abstract about transmission to the mother through breastfeeding. I'm not sure why a BLOG is cited instead of the actual article). Also, one of the sources is a broken link. This is a bit confusing because the third citation is actually about mother to child transmission...
Admittedly, I couldn't get access to the paper that the abstract was for, but I couldn't find any mention in any of the 3 sources of "heavy duty rubber gloves" or "face masks" and I don't really know what "mouth contact" means, because I'm pretty sure that just swapping saliva isn't supposed to be a means of transmission for HIV. (Actually, I think it's referring to infant-mother transmission through breastfeeding, but this is not really "mouth contact").
- edit*
also, the next paragraph talks about "parental and infant" deaths, which again seems to be referencing infant-mother transmission. But the article cited says nothing about this. The article talks about the effects AZT has had on people in general and on mother-infant transmission specifically. But nothing about parents specifically. 74.111.185.23 (talk) 05:55, 21 February 2014 (UTC)
Plans to improve page
Hi there,
I'm part of a group of 4 pharmacy students at UCSF. We are planning on making slight edits to this page to improve content and readability. Here is a brief description of some of the changes we plan on making.
- Simplification of medical jargon, especially under adverse effects and pharmacokinetic properties.
- Review and update older sources from the 80s/90s.
- Correct grammatical issues such as run-on sentences, particularly under "HIV Treatment" and "HIV Prevention".
- Add sources for claims without a source.
- The Viral Resistance section is simply a repeat of what was stated in the HIV Treatment section.
- Mechanism of action is missing a citation.
- Perhaps the page could benefit from splitting the discussion about AZT's toxicity to our own cells and specificity to HIV into two separate paragraphs.
- Maintain objective tone throughout the entire page.
- Society and Culture: The drug was featured heavily in the Matthew McConaughey movie, Dallas Buyers Club.
- History: The short paragraph regarding 6MP may not be necessary/relevant. Also, there's a sentence explaining what reverse transcriptase is even though it is already linked and explained earlier.
- Address other issues brought up in the talk page, specifically the suggested edit in 2014 under "confusing sentence/inconsistent paragraph".
Iaminwillmart (talk) 18:18, 4 November 2016 (UTC)
- That all seems great. Please make sure you use WP:MEDRS sources for all WP:Biomedical information and WP:RS for the rest. Not too excited about the movie thin; there is no end to that sort of thing and it generally becomes a magnet for low quality additions. Jytdog (talk) 20:18, 4 November 2016 (UTC)
Student Review #3
Upon review, the overall structure of the edits is consistent with Misplaced Pages's manual of style for medicine-related articles. The introduction is succinct and gives a great overview of the medication while not getting too specific in terms of topics that follow in later sections. The flow of introduction --> Medical Uses --> Side effects --> Mechanism --> Chemistry --> History is logical with respect to formatting. The only recommendations that I have are to change the title of" Side Effects" to "Adverse Effects" and "Mechanism" to "Mechanism of Action" to keep heading format consistent across medication-related wikipedia articles.
Mkw 09 (talk) 02:57, 15 November 2016 (UTC)
- whether the structure is "logical" to you is irrelevant. The structure complies with WP:MEDMOS and the lead complies with WP:LEAD. You and the other students need to read WP:MEDRS, WP:MEDMOS, and the other policies and guidelines and base your review on them, and only on them. We do not capitalize headers that way per the general manual of style, WP:MOS. Jytdog (talk) 03:20, 15 November 2016 (UTC)
Does the draft submission reflect a neutral point of view? If not, specify…
The group submission did not reflect any personal opinions and points of view about the drug, Zidovudine. Everything was written in the format of using the drug name or "it". They did not use "I", "we", "my" or "our" in their edits. They also did not encourage or discourage the use of the drug. They simply discussed a simple background, medical uses, side effects and mechanism of action. At the end of the article, a law suite against the drug was discussed but it did not take sides in the discussion. Instead they presented the argument from each party. — Preceding unsigned comment added by Elmira.Z (talk • contribs) 20:11, 15 November 2016 (UTC)
Student #2
STUDENT 2 – Are the points included verifiable with cited secondary sources that are freely accessible? If not, specify…
Yes majority of points included are verifiable with cited secondary sources that are freely accessible. Source #61 was a broken link and source #56 is not "freely accessible." Overall, the group utilized many reputable sources that are in fact freely accessible when editing the Zidovudine page. — Preceding unsigned comment added by Ceb333 (talk • contribs) 20:30, 15 November 2016 (UTC)
- Removing a source because it is behind a paywall violates Misplaced Pages policy. See WP:PAYWALL. If you can find a ref that is as good or better (say a more recent review) that is free that is great and you can replace a paywalled article with that, but never reduce source quality or leave something unsourced due to the free/not free criterion. The most important thing is high-quality sourcing and content summarizing those sources accurately. Jytdog (talk) 10:53, 17 November 2016 (UTC)
Cultural history of AZT
This article could do with a lot of work on the cultural history of AZT during the early part of the AIDS crisis, as well as more detail on its efficacy as a monotherapy (as it was used through the 1980s) and the amount of research into it that went on under Tony Fauci's leadership of NIAID, to the exclusion of other therapies.
Hopefully someone can beat me to it, but David France's book How to Survive a Plague would be a good place to start and the Writings of Michael Callen could be useful (Michael Callen was strongly opposed to the initial — overdosed and toxic — use of AZT monotherapy in the 1980s, which was later shown to be of minimal therapeutic value); I would expect that Randy Shilts's And the Band Played On might also have useful information. I recently did a load of work on the biography of early AIDS activist Bobbi Campbell and some of the references I used there might also be helpful. — OwenBlacker (Talk) 14:04, 13 January 2017 (UTC)
Agreed. The article currently reads like an advertisement.121.219.26.30 (talk) 03:34, 12 October 2017 (UTC)
1987
These two refs
https://books.google.ca/books?id=zNCJmuWgHAoC&pg=PA179#v=onepage&q&f=false
https://www.drugs.com/monograph/zidovudine.html
support the date as 1987 plus it being the first and are better than an old NYTs article which only supports part of it. Doc James (talk · contribs · email) 20:16, 11 February 2019 (UTC)
Categories:- Selected anniversaries (March 2005)
- Selected anniversaries (March 2006)
- Selected anniversaries (March 2007)
- Selected anniversaries (March 2008)
- Selected anniversaries (March 2009)
- Selected anniversaries (March 2010)
- Selected anniversaries (March 2011)
- Selected anniversaries (March 2013)
- Selected anniversaries (March 2016)
- Selected anniversaries (March 2018)
- Selected anniversaries (March 2020)
- Selected anniversaries (March 2021)
- Selected anniversaries (March 2024)
- B-Class level-5 vital articles
- Misplaced Pages level-5 vital articles in Biology and health sciences
- B-Class vital articles in Biology and health sciences
- B-Class AIDS articles
- Top-importance AIDS articles
- WikiProject AIDS articles
- B-Class pharmacology articles
- High-importance pharmacology articles
- WikiProject Pharmacology articles
- B-Class virus articles
- High-importance virus articles
- WikiProject Viruses articles
- B-Class medicine articles
- Mid-importance medicine articles
- All WikiProject Medicine pages