Failure of Zidovudine Prophylaxis after Accidental Exposure to HIV-1

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Abstract
ON the basis of encouraging data from two studies in animals,1 , 2 the manufacturer of the antiretroviral nucleoside analogue zidovudine (formerly azido--thymidine [AZT]) has initiated a placebo-controlled trial to assess the chemoprophylactic efficacy of zidovudine after occupational or nosocomial exposure to the human immunodeficiency virus type 1 (HIV-1).3 , 4 It is unlikely, however, that this trial will be completed soon, given the relatively low risk of infection through occupational exposure.4 In anticipation of the results of the study, several programs of zidovudine chemoprophylaxis for health care workers who have been occupationally exposed to HIV-1 have been implemented.4 The aftermath of a tragic accident in our hospital reveals that even when it is begun very soon after exposure, treatment with zidovudine will not necessarily prevent HIV-1 infection.