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

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