The effects of azidothymidine therapy on pseudocholinesterase concentrations in asymptomatic HIV-positive patients

The purpose of this study was to determine if a correlation exists between long-term azidothymidine (AZT) therapy and low pseudocholinesterase concentrations in patients who are infected with the human immunodeficiency virus (HIV). A pilot study was conducted of 10 patients infected with HIV, 5 of whom were receiving AZT. Laboratory tests, including complete blood count (CBC), liver function tests, helper/inducer T lymphocyte numbers (CD4), serum dibucaine numbers, and serum pseudocholinesterase concentrations were examined. Control and study subjects both exhibited normal dibucaine numbers, but the pseudocholinesterase concentrations were significantly lower in the group that was not receiving AZT relative to the AZT treatment group. However, only two patients, neither of whom were receiving AZT, demonstrated low or borderline low pseudocholinesterase concentrations according to laboratory criteria. It is possible that pseudocholinesterase synthesis is significantly inhibited by the HIV disease process and that treatment with AZT partly reverses the inhibition. Associated variables contributing to low pseudocholinesterase concentrations in the HIV-positive patient are explored.