Talk:Zidovudine

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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 ^Talk 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) Wikipedia's rules:^simple/_complex 18:14, 16 December 2010 (UTC)

This might be a useful review article. [1] 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 ^Talk 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.[26] Because of this selectivity, in vitro studies have shown that AZT inhibits HIV replication without affecting the function of normal T cells.[8]

The two footnotes [26, 8] are from 1986 and 1985, respectively. I move that the above statement be amended as follows:

Early studies [26, 8] 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 [insert ref's 1&2 above] 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 ^Talk 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) Wikipedia's rules:^simple/_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 [The numbers are not the footnote-numbers]: 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: . .. [the sources] 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) 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. WLU (t) (c) Wikipedia's rules:simple/complex 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. This is the version I believe is being worked from. WLU (t) (c) Wikipedia's rules:simple/complex 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? 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) 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 shun time. 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 Citizendium, 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 eukaryotic 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. WLU (t) (c) Wikipedia's rules:simple/complex 23:21, 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) Given your ignorance of basic biology, I'm not surprised. WLU (t) (c) Wikipedia's rules:simple/complex 04:15, 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) Your views are the idiosyncratic ones. Please stop pushing this fringe views here. Several editors appear to be invoking WP:SHUN, which is advisable here. Lay down the stick and move on. Yobol (talk) 03:40, 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 Wikipedia 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 Wikipedia's policy on neutrality, as well as our article on AIDS denialism and the FAQ at the top of Talk:HIV. Adrian J. Hunter^{(talk•contribs)} 06:48, 1 April 2012 (UTC)

• For starters, how about this sentence from the article: "AZT has been certified as non-carcinogenic, non-mutagenic[10] and non-clastogenic[11] 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.[43]" — 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 ^Talk 18:26, 3 April 2012 (UTC)

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 [10], [11], and [43], 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 ^Talk 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 ^Talk 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 ^Talk 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 ^Talk 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^{(talk•contribs)} 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. 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 "[AZT] is recognized by the Centers for Disease Control as one of the most safe^[2] and effective^[3] drugs in medical history.^[4]" 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 Wikipedia:Citing sources, section Text–source integrity. Adrian J. Hunter^{(talk•contribs)} 23:47, 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 Wikipedia'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 Wikipedia 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 [lack of] 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)