Document 0176
 DOCN  M94A0176
 TI    Zidovudine reduces intrathecal immunoactivation in patients with early
       human immunodeficiency virus type 1 infection.
 DT    9412
 AU    Elovaara I; Poutiainen E; Lahdevirta J; Hokkanen L; Raininko R; Mattinen
       S; Virta A; Suni J; Ranki A; Department of Infectious Diseases, Aurora
       Hospital, Helsinki,; Finland.
 SO    Arch Neurol. 1994 Sep;51(9):943-50. Unique Identifier : AIDSLINE
       MED/94361638
 AB    OBJECTIVE: To evaluate the effect of zidovudine on human
       immunodeficiency virus type 1 (HIV-1)-associated central nervous system
       infection in Centers for Disease Control and Prevention stage II or III
       disease. DESIGN: In an open-ended trial, patients received 500 mg of
       zidovudine twice a day for 12 months. Lumbar punctures, neurological,
       neuropsychological, and neuroradiological examinations were repeatedly
       performed during the trial period and were compared with pretrial
       values. In 11 patients post-trial neurological follow-up of 10 to 20
       months was performed. PATIENTS: Initially, 14 volunteers with stage II
       or III disease and intrathecal synthesis of HIV-1-specific antibodies
       were enrolled. Additionally, patients had slight neuropsychological
       disturbance or brain atrophy unrelated to other agents than HIV-1. Two
       patients dropped out because of poor compliance. MAIN OUTCOME MEASURES:
       Intrathecal and systemic immune and virological responses, cognitive
       performance, and brain images were repeatedly monitored. RESULTS: After
       6 weeks of zidovudine therapy, initial low-grade pleocytosis and
       elevated levels of beta 2-microglobulin, both in cerebrospinal fluid and
       in serum samples, declined. Intrathecal HIV-1 antibody synthesis could
       no longer be detected in half of the patients after 12 months of
       zidovudine therapy. Patients with defective cognition transiently
       improved cognitive speed and flexibility after 6 months of therapy.
       Slight atrophic brain changes, however, remained unchanged. CONCLUSIONS:
       Zidovudine reduces intrathecal immuno-activation and transiently
       improves cognitive functioning in HIV-1-infected subjects who show
       evidence of central nervous system involvement by HIV-1 but are
       otherwise asymptomatic.
 DE    beta 2-Microglobulin/ANALYSIS/CEREBROSPINAL FLUID  Adult  Central
       Nervous System Diseases/*DRUG THERAPY/ETIOLOGY/IMMUNOLOGY  Cognition
       Disorders/ETIOLOGY  CD4-CD8 Ratio  Human  HIV
       Antibodies/ANALYSIS/BIOSYNTHESIS  HIV Infections/COMPLICATIONS/*DRUG
       THERAPY/*IMMUNOLOGY  HIV-1/IMMUNOLOGY  IgG/BIOSYNTHESIS  Male  Middle
       Age  Support, Non-U.S. Gov't  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).