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Document 2923
DOCN M94A2923
TI HIV-1 associated cognitive-motor complex in Europe. The AIDS in Europe
Study Group.
DT 9412
AU Chiesi A; Dally LG; Vella S; Lundgren JD; Pedersen C; Istituto Superiore
di Sanita, Lab. of Virology, Rome, Italy.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):194 (abstract no. PB0204). Unique
Identifier : AIDSLINE ICA10/94369652
AB OBJECTIVE: To investigate the epidemiology of ADC in Europe through
information collected on 6548 subjects who were diagnosed AIDS between
Jan. 1980 and Dec. 1989 and who were enrolled in a multicenter European
study sponsored by the Commission of the European Communities. We also
attempted to assess the role of ZDV therapy in preventing or delaying of
ADC and on the survival of ADC patients. METHODS: Data were
retrospectively collected at 52 European Clinical Centers and included
age at diagnosis, gender, risk group, year of AIDS diagnosis, CD4+ cells
count at AIDS diagnosis and times of initiation and permanent
discontinuation of ZDV treatment. The occurrence of other AIDS defining
diseases during the follow up period, cause and date of death, where
appropriate, were also recorded. Multiple logistic regression was used
to investigate factors associated with the occurrence of ADC at AIDS
diagnosis, whereas Kaplan-Meier estimates, logrank tests and the Cox
proportional hazards model were used to analyse the rate of the
occurrence of ADC, after AIDS diagnosis, and survival. RESULTS: In the
considered population patients were predominantly males (91.2%) and
homosexuals (60.5%) although there were wide regional differences. The
overall mean age at AIDS diagnosis was 35.5 years, but the IVDU risk
group was significantly younger. CD4+ cells count at AIDS diagnosis was
available for only 3046 patients, the overall mean being 93.7 cells/mm3.
Of those who were not diagnosed AIDS due to ADC, a total of 2595 began
ZDV treatment either before or after AIDS diagnosis. Overall, ADC was
diagnosed in 697 (10.6%) cases, of which 295 (4.5%) occurred at time of
AIDS diagnosis and the remaining 402 (7.8%) cases occurred after AIDS
diagnosis. A positive corrispondence was found between the incidence of
ADC at AIDS diagnosis and sex, age, IVDU risk group and region. The log
of CD4+ was only just significant at the 5% level, the risk increasing
with decreasing CD4+ counts. Including ZDV as a time-dependent covariate
in the Cox model, treatment was found to significantly (p = 0.0001)
reduce the risk of developing ADC, after AIDS, only during the first 18
months of treatment, by about 40%. Subjects with ADC at AIDS diagnosis
(with or without other diseases) have a 60% increased risk with respect
to survival. CONCLUSIONS: Our results clearly show that factors having a
role in determining the risk of ADC, either before or after AIDS
diagnosis, are age, gender, region, risk group and CD4+ cell count. In
particular, we confirm previous results that IVDU's have a much higher
risk of ADC compared to Homosexuals. It is also confirmed that ZDV
treatment reduces the risk of developing ADC, even though this benefit
seems to be lost if treatment is continued for more than 18 months.
DE Adult AIDS Dementia Complex/DRUG THERAPY/*EPIDEMIOLOGY/MORTALITY
Cross-Sectional Studies Europe/EPIDEMIOLOGY Female Follow-Up Studies
Human *HIV-1/DRUG EFFECTS Incidence Male *Neuropsychological Tests
Retrospective Studies Risk Factors Survival Rate
Zidovudine/THERAPEUTIC USE CLINICAL TRIAL MEETING ABSTRACT
MULTICENTER STUDY RANDOMIZED CONTROLLED TRIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).