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1994-10-25
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Document 2365
DOCN M94A2365
TI Prognostic value of neurological signs in acute HIV infection. SEROCO
Study Group.
DT 9412
AU Bachmeyer C; Boufassa F; Sereni D; Deveau C; Carre N; Bucquet D;
Department of Internal Medicine, Hopital Cochin, Paris, France.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):320 (abstract no. PC0209). Unique
Identifier : AIDSLINE ICA10/94370210
AB OBJECTIVE: To assess the prognostic value of neurological signs in acute
symptomatic HIV-1 infection on the disease progression. METHODS: From
January 1988 to January 1992, 1453 non-hemophiliac adult patients (pts)
were enrolled in a french multicentric cohort (SEROCO). Out of them, 277
were included within the first year after HIV infection. We evaluated
the prognostic value of major neurological (group N+) and non-neurologic
(group N-) signs in acute HIV infection vs asymptomatic seroconversion
(group A). End points were CD4 cell count < 500/mm3 and AIDS onset.
Prognostic variables were included in a Cox model. RESULTS: Acute HIV-1
infection occurred in 135 patients (48.7%). Out of them, 112 (83.0%)
experienced non-neurologic signs, 23 (17.0%) neurological signs
consisting of symptomatic meningitis or encephalitis (n = 10) and
neuritis or polyradiculoneuritis (n = 13). Asymptomatic seroconversion
was observed in 142 patients. All groups were comparable for sex, time
between first positive serology and inclusion, age at infection, route
of infection and CD4 cell count at inclusion. Mean follow-up was 39.5
months in all groups. CD4 cell count < 500/mm3 was observed in 87.0% of
pts (n = 20) in group N+, 74.1% (n = 83) in group N-, and 78.2% (n =
111) in group A (p = 0.04). AIDS developed in 21.7% of pts (n = 5),
11.6% (n = 13) and 4.9% (n = 7) respectively in the same 3 groups (p =
0.01). Relative risk of CD4 cell count < 500/mm3 was 1.73 (p = 0.03) in
group N+ vs group A (group N- vs group A, p = 0.9). Relative risk of
developing AIDS was 6.2 (p = 0.005) and 2.35 (p = 0.06) in groups N+ and
N- vs group A. Neurological signs in acute HIV infection were an
independent risk factor for AIDS (RR = 4.66; p = 0.01), after taking
into account age at infection and treatment as a time-dependent
variable. DISCUSSION AND CONCLUSIONS. Acute HIV-1 infection with
neurological signs is a predictor of rapid CD4 cell count < 500/mm3 and
progression to AIDS independently of age at seroconversion and
treatments during follow-up.
DE Acquired Immunodeficiency Syndrome/COMPLICATIONS Acute Disease Adult
Human HIV Infections/*COMPLICATIONS *HIV-1 Leukocyte Count Nervous
System Diseases/*COMPLICATIONS/DIAGNOSIS Prognosis T4 Lymphocytes
MEETING ABSTRACT MULTICENTER STUDY
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).