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M9630233.TXT
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1996-02-27
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Document 0233
DOCN M9630233
TI Changing incidence of HIV-induced brain lesions in Oslo, 1983-1994:
effects of zidovudine treatment.
DT 9603
AU Maehlen J; Dunlop O; Liestol K; Dobloug JH; Goplen AK; Torvik A;
Department of Pathology, Ulleval University Hospital, Oslo,; Norway.
SO AIDS. 1995 Oct;9(10):1165-9. Unique Identifier : AIDSLINE MED/96098133
AB OBJECTIVE: To investigate the relation between HIV-induced brain
lesions, zidovudine (ZDV) treatment and survival length in a
well-defined population of HIV-positive patients. METHODS AND PATIENTS:
Ulleval Hospital has the responsibility for treating all AIDS patients
from the city of Oslo except haemophiliac patients. The patient
population in this autopsy study comprised all adult AIDS patients in
Oslo who were treated at our hospital and died during 1983-1994 (n =
171). This represents 86% of all adult AIDS patients from Oslo who died
during the same period. Full autopsy, including neuropathological
examination of the brain and spinal cord, was performed on 128 (75%) of
those who died. RESULTS: No significant differences were found between
autopsy and non-autopsy cases with regard to sex, age, risk groups,
survival length or ZDV treatment. In the autopsy material,
multinucleated giant cells (MGC) in brain tissue were found in 29 cases
and diffuse damage of white matter in 52 cases. Analysis shows that ZDV
(600 mg per day) reduced the incidence of these brain lesions, but only
if continued until death. A second finding was an increased incidence of
HIV-induced brain lesions for those with long-term survival. Together
these observations may explain a substantial part of the time-trend in
the incidence of MGC in Oslo. MGC were frequent (40%) during the first
years of the epidemic, although survival length was short in this
period. The incidence fell markedly around the time ZDV was introduced
and later remained low in those using ZDV until death. The incidence of
MGC has, however, increased during the later years, the new cases mainly
occurring in patients who had discontinued ZDV use. CONCLUSION: If
continued until death, ZDV can reduce the incidence of HIV-induced brain
lesions in AIDS patients. When ZDV treatment is terminated a rapid
increase occurs in the incidence of HIV encephalitis.
DE Acquired Immunodeficiency Syndrome/COMPLICATIONS/*DRUG THERAPY/
MORTALITY Adult Aged Antiviral Agents/*THERAPEUTIC USE
Brain/*PATHOLOGY Brain Diseases/ETIOLOGY/PATHOLOGY Cytopathogenic
Effect, Viral Encephalitis, Viral/MORTALITY/PREVENTION & CONTROL
Female Giant Cells/DRUG EFFECTS/*PATHOLOGY Human Male Middle Age
Norway Regression Analysis Support, Non-U.S. Gov't Survival Rate
Zidovudine/*THERAPEUTIC USE CLINICAL TRIAL JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).