Document 2889
 DOCN  M94A2889
 TI    Pilot study of zidovudine (AZT) and zalcitabine (ddC) combination in
       HIV-associated dementia.
 DT    9412
 AU    McIntyre K; Torres R; Luck D; Tavalouras G; St. Vincent's Hospital and
       Medical Center of New York, N.Y.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):201 (abstract no. PB0233). Unique
       Identifier : AIDSLINE ICA10/94369686
 AB    OBJECTIVE: To evaluate the safety and efficacy of zidovudine (AZT) and
       zalcitabine (ddC) combination therapy in patients with HIV-associated
       dementia, who have been previously treated with zidovudine. METHODS:
       HIV-infected patients were eligible for the study if they had received
       zidovudine for a minimum of 4 weeks and had obtained abnormal scores on
       at least two of six neuropsychological tests and had no other organic or
       psychological cause of dementia. All patients had baseline and
       neuropsychological testing, neurological examinations, lumbar punctures,
       CT or MRI scans and SPECT scans before starting therapy with zidovudine
       600 mg/day and zalcitabine 2.25 mg/day. After 8 weeks of therapy,
       neuropsychological tests, neurological exams and lumbar punctures were
       repeated. CSF and serum HIV-RNA titers at baseline and at 8 weeks were
       determined with quantitative PCR and concentrations of both nucleosides
       were determined in plasma and CSF samples at 8 weeks. RESULTS: Four
       patients with mild-to-moderate HIV-associated dementia who met
       eligibility criteria were treated with the combination of nucleosides
       for 8 weeks. Three patients who completed the 8 weeks of treatment were
       evaluable. The mean serum and CSF HIV-RNA titers of 2 patients decreased
       from 26,685 and 786 to 16,742 and 66, respectively. Neuropsychological
       scores improved in all three patients after 8 weeks of therapy, and a
       53% improvement from baseline was observed in macro-neurological
       function. No adverse experiences were noted. CONCLUSION: Combination
       therapy with zidovudine and zalcitabine is effective in reversing
       neurocognitive dysfunction and serum and CSF HIV-RNA titers in patients
       with HIV-associated dementia.
 DE    AIDS Dementia Complex/*DRUG THERAPY/MICROBIOLOGY/PSYCHOLOGY  Drug
       Therapy, Combination  Human  HIV/ISOLATION & PURIF  Neuropsychological
       Tests  Pilot Projects  RNA, Viral/BLOOD/CEREBROSPINAL FLUID  Treatment
       Outcome  Viremia/DRUG THERAPY  Zalcitabine/ADMINISTRATION &
       DOSAGE/*THERAPEUTIC USE  Zidovudine/ADMINISTRATION & DOSAGE/*THERAPEUTIC
       USE  CLINICAL TRIAL  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).