Kofi Nuako, MD
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To the editors: The editorial by Lagakos and Hoth (1) addresses an interesting aspect of clinical trials involving the acquired immunodeficiency syndrome (AIDS). Some of their statements are, however, too broad. For example, surrogate markers are not necessary when dealing with conditions with well-defined therapeutic parameters and goals (for example, normal thyroid function tests in thyroxine replacement or gastric pH above 4 in antacid prophylaxis of stress ulcer).
The use of a CD4 count of 200 as a threshold in the quantitative Centers for Disease Control (CDC) definition of AIDS no longer qualifies it a surrogate marker. Zidovudine (AZT) remains
Nuako K. Surrogate Markers in AIDS. Ann Intern Med. ;117:619. doi: 10.7326/0003-4819-117-7-619_1
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Published: Ann Intern Med. 1992;117(7):619.
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