A regimen of intrauterine AZT (zidovudine) as a means of reducing the

Question

A regimen of intrauterine AZT (zidovudine) as a means of reducing the chances of HIV transmission from mother to child was first described in a study known as Protocol 076, the results of which were published in the New England Journal of Medicine in November 1994. The trial found that administration of AZT to HIV-positive women during pregnancy and delivery, and to their babies after birth, reduced the transmission of HIV to the infants by two thirds, compared with a placebo. The study was acclaimed as one of the first successful instances of a prophylaxis preventing HIV transmission—particularly “vertical” transmission, or transmission from mothers to infants. The study, prematurely ended so that all the subjects on placebos could be switched to AZT, led to the recommendation that all pregnant women with HIV take AZT.

The validity of the study’s results, however, is debatable. Since Protocol 076 examined only women who had fairly high numbers of T-cells—the white blood cells that coordinate immune response—and who had previously taken AZT for less than six months, the same regimen might not succeed for other pregnant women with HIV. Moreover, the study administered large doses of AZT without examining whether lower doses, more economically feasible for uninsured or under insured women, might be effective. Further, the trial design did not account for important variables: in particular, whether the subjects’ viral load—the amount of HIV in their bodies—might have contributed to the difference in transmission rates. Since the exact mechanism and timing of vertical transmission of the HIV virus are unknown, it cannot be ruled out that viral load influences rates of vertical transmission.

Also, the study did not consider the long term impact of AZT, which is toxic, on the babies themselves. There have been few studies of AZT’s effect on HIV-positive infants and none on its effects on uninfected babies. Since the majority of the babies born to HIV-positive women are HIV-negative, and since HIV may mutate into drug-resistant strains following a break in medication, the value of a short term “zap” with AZT becomes suspect.   1 
 Q1. The author questions the results of Protocol 076 for which of the following reasons? 
 
A. The number of T-cells was not considered in choosing subjects for the study.
B. The trial was discontinued, and the control group of women on placebo was shifted to AZT.
C. Seventy-five percent of babies born to women in the placebo group were free of infection with HIV.
D. Different transmission rates could have been influenced by different amounts of HIV in the women’s bodies.
E. The exact mechanism and timing of HIV transmission are unknown.
 2 
 Q2. The author of this passage would be LEAST likely to challenge the benefits of intrauterine AZT for which of the following HIV-positive women and/or their future children?

A. A woman who has used the regimen successfully in a previous pregnancy
B. A woman whose T-cell count is dangerously low and who plans to continue taking AZT after her baby is born
C. A woman who is matched with the study’s subjects in terms of ethnicity and socioeconomic status
D. A woman who has lost a previous infant to HIV and who wants to be sure that her next child is healthy
E. A woman whose T-cell count is not low and who has not taken AZT before
 3 
 Q3. The passage implies that the “viral loads” of the subjects in the study are significant because

A. all the subjects had relatively high viral loads, so the study’s results may not apply to other groups of women.
B. the viral loads of babies whose mothers had received the placebo were just as high as those of babies whose mothers had received AZT.
C. viral load must be measured if researchers are to understand the exact mechanism and timing of transmission of HIV.
D. the viral loads of women in the placebo group may have been different from those of women in the AZT group.
E. viral load may be a critical factor in determining transmission, but the researchers wrongly assumed that it was the only factor.
 4 
 Q4. The primary purpose of the passage is to

A. document recent problems with HIV and AIDS treatment.
B. expose medical errors caused by the careless methodology in an important clinical trial.
C. raise doubts about a course of treatment based on a groundbreaking study.
D. describe the process of vertical transmission of HIV and suggest preventive therapy.
E. evaluate treatment possibilities for pregnant women with HIV.
 5 
 Q5. The author of the passage would be most likely to agree with which of the following statements?

A. Medications harmful to one group of patients are probably not harmful to another.
B. Recommendations based on a conditional experiment must be qualified.
C. The study should not have been prematurely ended.
D. Clinical trials that may harm patients are unethical.
E. No HIV-positive woman should take AZT during pregnancy.
 6 
 Q6. The primary function of the second paragraph is to

A. refute issues.
B. evaluate solutions.
C. describe results.
D. support action.
E. identify problems.

Sreyoshi007 · Accepted Answer

5 mins, including time to read the passage, 5/6 correct 1. Refer to the following lines in the passage : Based on this, option D makes the most sense and is the right answer. 2. I got this one wrong, I was confused between options B and E and incorrectly chose B. But on re-reading the passage I noticed the following lines So, from this we can understand why E is better . For women who have not taken AZT, the medication will not be resistant and hence will work. I am not sure if my reasoning is correct, workout please clarify. 3. Again referring to the following lines from the passage: The passage mentions that the viral loads were significant because they cast a doubt on the validity of the study's results. This further can imply that the viral load of the group of women in the two groups may be different and hence they are significant. Answer option D is correct. 4. The primary purpose of the passage is to raise doubts on the validity of a particular treatment. This is best captured in answer option C . 5. We can solve this by POE. A. This is too generic and this has not been mentioned in the passage. We can eliminate A. B. Yes, this makes sense. We can infer from the passage that results from an experiment need to be qualified. Correct. C. The passage states that the study was prematurely ended but nowhere is the judgement made whether the study should not have ended prematurely or not. Eliminate C. D. Not mentioned in the passage, out of scope. Eliminate. E. Too extreme, not mentioned that no HIV-positive woman should take AZT during pregnancy. B is the correct answer. 6. The second paragraph gives us the reasons why the result of the study is debatable. Refer to lines : Considering this, answer option E is correct as we do identify the problems. If someone could clarify my reasoning for Q2, it would be great! Thanks,

OC2910 · Answer

Q1. The author questions the results of Protocol 076 for which of the following reasons?

A. The number of T-cells was not considered in choosing subjects for the study.
B. The trial was discontinued, and the control group of women on placebo was shifted to AZT.
C. Seventy-five percent of babies born to women in the placebo group were free of infection with HIV.
 D. Different transmission rates could have been influenced by different amounts of HIV in the women’s bodies. 
E. The exact mechanism and timing of HIV transmission are unknown.
the main doubt is between D and E but reading the passage we see the it was failure to consider the presence of the factor :transmission rates and not the transmission mechanism that led to question the study 
 so D

Q2. The author of this passage would be LEAST likely to challenge the benefits of intrauterine AZT for which of the following HIV-positive women and/or their future children?

the author mentions in start of second para : high T cells and less than 6 months duration of AZT

A. A woman who has used the regimen successfully in a previous pregnancy--opposite
B. A woman whose T-cell count is dangerously low and who plans to continue taking AZT after her baby is born---opposite 
C. A woman who is matched with the study’s subjects in terms of ethnicity and socioeconomic status--- no correlation
D. A woman who has lost a previous infant to HIV and who wants to be sure that her next child is healthy--- no mention about this 
 E. A woman whose T-cell count is  not low  and who has  not taken  AZT before

Q3. The passage implies that the “viral loads” of the subjects in the study are significant because

A. all the subjects had relatively high viral loads, so the study’s results may not apply to other groups of women.
B. the viral loads of babies whose mothers had received the placebo were just as high as those of babies whose mothers had received AZT.
C. viral load must be measured if researchers are to understand the exact mechanism and timing of transmission of HIV.
 D. the viral loads of women in the placebo group may have been different from those of women in the AZT group. 
E. viral load may be a critical factor in determining transmission, but the researchers wrongly assumed that it was the only factor.

C and D close ; but C says the mechanism is important where as the author criticizes the failure to consider the rate of the transfer mechanism so D is correct (also gmat tip usage of must in C makes it bad choice)

Q4. The primary purpose of the passage is to

A. document recent problems with HIV and AIDS treatment.
B. expose medical errors caused by the careless methodology in an important clinical trial.
C.  raise doubts about a course of treatment based on a groundbreaking study. 
D. describe the process of vertical transmission of HIV and suggest preventive therapy.
E. evaluate treatment possibilities for pregnant women with HIV.

Q5. The author of the passage would be most likely to agree with which of the following statements?

A. Medications harmful to one group of patients are probably not harmful to another.
 B. Recommendations based on a conditional experiment must be qualified. 
C. The study should not have been prematurely ended.
D. Clinical trials that may harm patients are unethical.
E. No HIV-positive woman should take AZT during pregnancy.
slight dilemma between B and C but C wraps the truth ,author not concerned about the duration of study but the study as a whole: so B best

Q6. The primary function of the second paragraph is to

A. refute issues.
B. evaluate solutions.
C. describe results.
D. support action.
 E. identify problems.

OC2910 · Answer

Q2. The author of this passage would be LEAST likely to challenge the benefits of intrauterine AZT for which of the following HIV-positive women and/or their future children?

the author mentions in start of second para : high T cells and less than 6 months duration of AZT

A. A woman who has used the regimen successfully in a previous pregnancy--opposite
B. A woman whose T-cell count is dangerously low and who plans to continue taking AZT after her baby is born---opposite 
C. A woman who is matched with the study’s subjects in terms of ethnicity and socioeconomic status--- no correlation
D. A woman who has lost a previous infant to HIV and who wants to be sure that her next child is healthy--- no mention about this 
 E. A woman whose T-cell count is  not low  and who has  not taken  AZT before

naina0001 · Answer

Why the answer for Q1 is D not E as option E is clerarly stated in para last lines.

Posted from my mobile device

OC2910 · Answer

As far as I understood it was not option E although being stated is the reason for the study being disqualified but lack of considering the rates in the study was the reason so D is best

anupam87 · Answer

Q2. The author of this passage would be LEAST likely to challenge the benefits of intrauterine AZT for which of the following HIV-positive women and/or their future children?

A. A woman who has used the regimen successfully in a previous pregnancy 
B. A woman whose T-cell count is dangerously low and who plans to continue taking AZT after her baby is born 
C. A woman who is matched with the study’s subjects in terms of ethnicity and socioeconomic status 
D. A woman who has lost a previous infant to HIV and who wants to be sure that her next child is healthy
E. A woman whose T-cell count is not low and who has not taken AZT before

Can someone please explain why E is correct, based on the following statements from the passage I can understand that “A woman whose T-cell count is not low” is correct - 
 Since Protocol 076 examined only women who had fairly high numbers of T-cells—the white blood cells that coordinate immune response—and who had previously taken AZT for less than six months 
But the second part of the answer choice says that “who has not taken AZT before”, and the from the above statements from the passage it says that  “who had previously taken AZT for less than six months”

aragonn · Answer

P1 - AZT its usefulness
P2 - contrast from P1; 
P3 - more bad roles of AZT

Main point - AZT is good in certain case, but bad in other many cases.

Q1. The author questions the results of Protocol 076 for which of the following reasons?
this is done in p2 and p3

D. Different transmission rates could have been influenced by different amounts of HIV in the women’s bodies. - yes ; in particular, whether the subjects’ viral load—the amount of HIV in their bodies—might have contributed to the difference in transmission rates.
------------------------------------------------
Q2. The author of this passage would be LEAST likely to challenge the benefits of intrauterine AZT for which of the following HIV-positive women and/or their future children?
answer should be in P1/p2. ---- women who had fairly high numbers of T-cells—the white blood cells that coordinate immune response—and who had previously taken AZT for less than six months, the same regimen might not succeed for other pregnant women with HIV.

A. A woman who has used the regimen successfully in a previous pregnancy - no
B. A woman whose T-cell count is dangerously low and who plans to continue taking AZT after her baby is born - no
C. A woman who is matched with the study’s subjects in terms of ethnicity and socioeconomic status - no
D. A woman who has lost a previous infant to HIV and who wants to be sure that her next child is healthy - no
E. A woman whose T-cell count is not low and who has not taken AZT before - yes

-----------------------------------------------

Q3. The passage implies that the viral loads” of the subjects in the study are significant because
whether the subjects’ viral load—the amount of HIV in their bodies—might have contributed to the difference in transmission rates.

The trial found that administration of AZT to HIV-positive women during pregnancy and delivery, and to their babies after birth, reduced the transmission of HIV to the infants by two thirds, compared with a placebo.

D. the viral loads of women in the placebo group may have been different from those of women in the AZT group. - y

-----------------------------------------------

Q4. The primary purpose of the passage is to

A. document recent problems with HIV and AIDS treatment. - no
B. expose medical errors caused by the careless methodology in an important clinical trial. - yes but aim of author is to reject AZt.
C. raise doubts about a course of treatment based on a groundbreaking study. - more close to main point.
D. describe the process of vertical transmission of HIV and suggest preventive therapy. - no
E. evaluate treatment possibilities for pregnant women with HIV. - no

----------------------------------------------
Q5. The author of the passage would be most likely to agree with which of the following statements?

A. Medications harmful to one group of patients are probably not harmful to another. - too braod
B. Recommendations based on a conditional experiment must be qualified. - closest
C. The study should not have been prematurely ended. - no; not mentioned.
D. Clinical trials that may harm patients are unethical. - no; not mentioned. 
E. No HIV-positive woman should take AZT during pregnancy. - no; too braod

----------------------------------------------
Q6. The primary function of the second paragraph is to
Contrast the p1

E. identify problems. - has to be this.

honneeey · Answer

Here are my 2 cents-

Q1. The author questions the results of Protocol 076 for which of the following reasons? 
 
A. The number of T-cells was not considered in choosing subjects for the study-Out of scope
B. The trial was discontinued, and the control group of women on placebo was shifted to AZT.-True but not the the reason author questions the study
C. Seventy-five percent of babies born to women in the placebo group were free of infection with HIV.-not seventy five percent but 66.66%(2/3) not (3/4).
D. Different transmission rates could have been influenced by different amounts of HIV in the women’s bodies- Correct  "Further, the trial design did not account for important variables: in particular, whether the subjects’ viral load—the amount of HIV in their bodies—might have contributed to the difference in transmission rates." 
E. The exact mechanism and timing of HIV transmission are unknown.

Q2. The author of this passage would be LEAST likely to challenge the benefits of intrauterine AZT for which of the following HIV-positive women and/or their future children?

A. A woman who has used the regimen successfully in a previous pregnancy-No author would discourage such a use!
B. A woman whose T-cell count is dangerously low and who plans to continue taking AZT after her baby is born-No author would discourage such a use!
C. A woman who is matched with the study’s subjects in terms of ethnicity and socioeconomic status-Out of scope
D. A woman who has lost a previous infant to HIV and who wants to be sure that her next child is healthy-No author would discourage such a use!
E. A woman whose T-cell count is not low and who has not taken AZT before- Correct , refer"Since Protocol 076 examined only women who had fairly high numbers of T-cells—the white blood cells that coordinate immune response—and who had previously taken AZT for less than six months, the same regimen might not succeed for other pregnant women with HIV."

Q3. The passage implies that the “viral loads” of the subjects in the study are significant because

A. all the subjects had relatively high viral loads, so the study’s results may not apply to other groups of women-Wrong! no where mentioned.
B. the viral loads of babies whose mothers had received the placebo were just as high as those of babies whose mothers had received AZT.-Wrong! no where mentioned.
C. viral load must be measured if researchers are to understand the exact mechanism and timing of transmission of HIV.-True but not the answer
D. the viral loads of women in the placebo group may have been different from those of women in the AZT group.- Correct  refer passage.
E. viral load may be a critical factor in determining transmission, but the researchers wrongly assumed that it was the only factor.-Incorrect, "WRONGLY ASSUMED" is no where inferred.

Q4. The primary purpose of the passage is to

A. document recent problems with HIV and AIDS treatment.-Wrong! nothing about AIDS!
B. expose medical errors caused by the careless methodology in an important clinical trial-Wrong! Careless methodology is too strong.
C. raise doubts about a course of treatment based on a groundbreaking study.- Correct , Author details a path breaking process and goes on to infer its limitations and doubts on the validity of study!
D. describe the process of vertical transmission of HIV and suggest preventive therapy.-Partial scope
E. evaluate treatment possibilities for pregnant women with HIV.-Partial scope.

Q5. The author of the passage would be most likely to agree with which of the following statements?

A. Medications harmful to one group of patients are probably not harmful to another.-Nowhere mentioned
B. Recommendations based on a conditional experiment must be qualified.- Correct , Author supports that the trial should be qualified !
C. The study should not have been prematurely ended.-Study did ended prematurely but author supports or refutes is no where mentioned.
D. Clinical trials that may harm patients are unethical.-Nowhere mentioned
E. No HIV-positive woman should take AZT during pregnancy.-Nowhere mentioned

Q6. The primary function of the second paragraph is to

A. refute issues.-Wrong! no issues are refuted.
B. evaluate solutions.-Umm, kinda right! Keep it for now!
C. describe results.-NO results are described rather the basis on which result is reached is described.
D. support action.-No suppor to action.
E. identify problems.-Kinda right! author does talks about problems!  Correct !

I will select E over B.

honneeey · Answer

Hi  workout ,

Please help me understand question no. 6!

Q6. The primary function of the second paragraph is to

A. refute issues.-Wrong! no issues are refuted.
 B. evaluate solutions.-Umm, kinda right! Keep it for now! 
C. describe results.-NO results are described rather the basis on which result is reached is described.
D. support action.-No suppor to action.
 E. identify problems.-Kinda right! author does talks about problems! Correct !

I was terribly divided between B and E but fortunately selected E but what is the major flaw in B?

Need your advice please  workout  !

mallya12 · Answer

Please Explain Q3. C vs D
Q5) B vs C

Rupesh1Nonly · Answer

Q3. C vs D

"Since the exact mechanism and timing of vertical transmission of the HIV virus are unknown, it cannot be ruled out that viral load influences rates of vertical transmission."
It implies Viral load could be the factor.
what if we can find the exact mechanism in which viral load did not play any role; Hence, statement 'C' which says viral load must be studied is wrong.
Option D: says viral load could be the factor: which is exactly passage implies.

Q5) B vs C

research can be prematurely ended therefore scientists ended the research, but research should be qualified to be prematurely ended.

Option B: research should be qualified

Hope this will help you.

Thanks = Kudos

KADELSANJAY · Answer

egmat   Souvik  can you please explain question no 2?

bM22 · Answer

Hi  KADELSANJAY ,

Let me know if this helps.

Q2. The author of this passage would be LEAST likely to challenge the benefits of intrauterine AZT for which of the following HIV-positive women and/or their future children?

A. A woman who has used the regimen successfully in a previous pregnancy
B. A woman whose T-cell count is dangerously low and who plans to continue taking AZT after her baby is born
C. A woman who is matched with the study’s subjects in terms of ethnicity and socioeconomic status
D. A woman who has lost a previous infant to HIV and who wants to be sure that her next child is healthy
E. A woman whose T-cell count is not low and who has not taken AZT before

Correct Answer : E ,
Explanation: as mentioned in the passage: "The validity of the study’s results, however, is debatable. Since Protocol 076 examined only women who had fairly high numbers of T-cells—the white blood cells that coordinate immune response—and who had previously taken AZT for less than six months, the same regimen might not succeed for other pregnant women with HIV.", implying that author is least likely to challenge benefits of intrauterine AZT, for a woman whose T-cell count is high and who has either not taken AZT before or has taken AZT for less than 6 months.
Option A: incorrect, there could be multiple factors for the successful application in previous pregnancy, also nothing has been mentioned in the passage, w.r.t the same.
Option B: incorrect, opposite of what's mentioned in the argument could be true.
Option C, D: not relevant.

Thanks.

thecoronafever · Answer

For me, confusion is between A and E. 
I discarded E for the following reasons:
1. "not low" does not mean "high". 
2. "who had previously taken AZT for less than six months" does not imply "who had not taken AZT at all".

For Option A, if the regime might have worked previously, then they might have been within the similar conditions as per other subjects, though those conditions might change in future but it was the remaining option which sounded right to me and I did not found author strictly mentioning anything against it.

How to reliably choose the correct answer in such situations?

bM22 · Answer

Hi  thecoronafever ,

The author is least likely to agree with Option A, and we can infer the same from the last para: 
"Also, the study did not consider the long term impact of AZT, which is toxic, on the babies themselves. There have been few studies of AZT’s effect on HIV-positive infants and none on its effects on uninfected babies.", implying that after effects of AZT are harmful for the babies, and author provides studies to prove the same, in turn implying that benefits of AZT are not likely to be present in the children of the women with successful pregnancies.

For Option E, its true that not low, does not mean high and that "who had previously taken AZT for less than six months" does not imply "who had not taken AZT at all", but their mention in the passage, leaves us with possibilities, which are not being challenged, implying that author is least likely to challenge them.

For such kinds of questions, always look for either mentions or evidences that challenge view presented in the options, because author would be unlikely to dispute them. Even in the question above, all of the options have been refuted by the author in some or the other way, so looking for the best fit would lead to a correct answer.

Hope this Helps.
Thanks.

A regimen of intrauterine AZT (zidovudine) as a means of reducing the

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A regimen of intrauterine AZT (zidovudine) as a means of reducing the

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