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M94A2890.TXT
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1994-10-25
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Document 2890
DOCN M94A2890
TI Electrophysiological evaluation of 2',3',-dideoxycytidine (ddC) caused
polyneuropathy. A follow-up study.
DT 9412
AU Roick H; von Giesen HJ; Jablonowski H; Arendt G; Department of Neurology
& Medicine, Heinrich-Heine-University,; Duesseldorf, FRG.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):201 (abstract no. PB0232). Unique
Identifier : AIDSLINE ICA10/94369685
AB 18 HIV-seropositive individuals (5 CDC II, 2 CDC III, 11 CDC IV; age
41.97 +/- 10.41 years) were followed-up by nerve conduction velocity
studies and clinical examination before and during an antiretroviral
therapy with 2',3',-dideoxycytidine (ddC) (3 * 0.01 mg/kg body
weight/day;). The mean follow-up time was 174 days, ranging from 28 to
529 days of ddC therapy. Nerve conduction velocity studies were
performed on the ulnar nerve (motor/sensory), the deep peroneal nerve
(motor) and the sural nerve (sensory) to find out electrophysiologically
detectable deficits of the peripheral nervous system. Results were
compared to those of 45 HIV-seropositives without antiretroviral
treatment and to those of 46 HIV-seropositives treated with
azidothymidine (AZT). The course of HIV-infection was progressive during
follow-up time. 2 CDC II and the 2 CDC III individuals entered CDC IV, 1
CDC II entered CDC III. The T4/T8 ratio started with 0.13 +/- 0.08
(0.01-0.26) and decreased to 0.07 +/- 0.06 (0.00-0.16). Before ddC
treatment there was electrophysiological evidence of demyelinating
sensorimotor polyneuropathy in 1 patient and for axonal sensory
polyneuropathy in another one (= 11%). During follow-up 10 patients
developed electrophysiologically detectable peripheral nerve deficits: 6
(= 33%) a pure demyelinating sensorimotor polyneuropathy, 3 (= 17%) a
mixed axonal-demyelinating sensorimotor polyneuropathy and 1 (= 6%) a
pure axonal sensory polyneuropathy. 8 patients (= 44%) became clinically
symptomatic of peripheral nerve damage. HIV-seropositives without
antiretroviral therapy developed pure demyelinating sensorimotor
polyneuropathy in 33% and pure axonal sensorimotor polyneuropathy in 4%.
The group treated with AZT showed pure demyelinating polyneuropathy in
23.9%, mixed axonal-demyelinating polyneuropathy in 2.2% and pure axonal
polyneuropathy in 2.2%. In summary, ddC-treated patients showed a higher
percentage of electrophysiologically detectable axonal nerve damage than
AZT or non-treated patients to be accompanied in 44% by clinical
symptoms. Further follow-up studies must clarify whether
electrophysiologically detectable peripheral nerve deficits are followed
sooner or later in every case by clinical symptoms thus would be reason
enough to stop antiretroviral treatment with ddC.
DE Comparative Study Demyelinating Diseases/CHEMICALLY
INDUCED/COMPLICATIONS/ PHYSIOPATHOLOGY Follow-Up Studies Human HIV
Infections/COMPLICATIONS/*DRUG THERAPY Neural Conduction Peripheral
Nervous System Diseases/*CHEMICALLY INDUCED/
COMPLICATIONS/PHYSIOPATHOLOGY Sensation Disorders/CHEMICALLY
INDUCED/COMPLICATIONS/ PHYSIOPATHOLOGY Treatment Outcome
Zalcitabine/*ADVERSE EFFECTS/THERAPEUTIC USE Zidovudine/ADVERSE
EFFECTS/THERAPEUTIC USE MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).