Use of zidovudine for drug misusers infected with human immunodeficiency virus

The use of zidovudine in drug misusers, especially current drug misusers, has not been extensively studied. Since periods of abstinence may be interspersed with drug misuse, it is necessary to establish the safety of zidovudine in injection drug misuse-related human immunodeficiency virus (HIV) infection under a variety of conditions. HIV serology became available in October 1985 and we have now examined medically 289 HIV seropositive patients, 85% of whom acquired their infection via injection drug misuse. Since March 1987 we have treated 40 individuals with zidovudine, 25 of whom were former or current injection drug misusers and one who was a heterosexual contact of a drug misuser. Eighteen patients were taking various types of opiates. Six of this latter group injected either occasionally or regularly whilst taking zidovudine. There were no adverse clinical events associated with zidovudine treatment and continued opiate drug misuse whether by mouth or by injection. Although defaults from clinic visits were a problem, these defaults were not associated with any particular form of drug misuse. Compliance with zidovudine therapy as judged by change in the mean corpuscular volume was no different for the various risk groups. In our experience it is possible to treat safely current and former drug misusers with zidovudine.