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

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