Declining incidence of AIDS dementia complex after introduction of zidovudine treatment

BMJ : British Medical Journal
P PortegiesJ Goudsmit

Abstract

To assess the incidence of the AIDS dementia complex and the presence of HIV I p24 antigen in cerebrospinal fluid in relation to zidovudine treatment. Retrospective study of a consecutive series of patients with AIDS from 1982 to 1988. An academic centre for AIDS. 196 Patients with AIDS and neurological symptoms examined from 1982 to 1988. Zidovudine treatment, which was introduced to The Netherlands on 1 May 1987 for patients with severe symptoms of HIV infection (Centers for Disease Control groups IVA, B, C, and D). Diagnosis of AIDS dementia complex and presence of HIV I p24 antigen in cerebrospinal fluid. The AIDS dementia complex was diagnosed in 40 of the 196 (20%) patients with AIDS. Thirty eight of 107 patients with AIDS (36%) not taking zidovudine developed the AIDS dementia complex compared with two of the 89 (2%) taking the drug (p less than 0.00001). The incidence of the AIDS dementia complex increased to 53% in the first half of 1987, after the introduction of zidovudine in May 1987, decreasing to 10% in the second half of 1987 and to 3% in 1988. Dementia was diagnosed before definition of the AIDS dementia complex (1986) according to DSM-III criteria and there was good agreement between diagnosis before and after ...Continue Reading

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