Document 2930 DOCN M94A2930 TI HIV independent factors influencing neuropsychological performance in ARC and AIDS individuals. DT 9412 AU Dally LG; Chiesi A; Tomino C; Floridia M; Seeber A; Vella S; ISS, Lab. of Virology, Rome, Italy. SO Int Conf AIDS. 1994 Aug 7-12;10(1):192 (abstract no. PB0198). Unique Identifier : AIDSLINE ICA10/94369645 AB INTRODUCTION: Our previous studies on the epidemiology of ADC in Italy (16813 pts. diagnosed between August 1987 and December 1993) showed that ADC, as the first AIDS defining disease, occurred in 9.1% IVDU's vs 5.2% homosexuals, the two groups being similar for mean CD4+ cell count. This finding rose the question of which factors could account for the higher incidence of ADC in the IVDU population. OBJECTIVE: To investigate the possible role of HIV independent factors in influencing neuropsychological performance and thus, indirectly, the diagnosis of AIDS dementia complex (ADC). METHODS: We analyzed data on 412 patients enrolled between Oct. 1990 and Dec. 1992 in two AZT vs DDI randomized, multicenter trials. The present analysis is of baseline data only. Together with clinical and haematoimmunological data, baseline information included score for Mini-Mental Status (MMS), Digit Symbol (DSY) and Timed Gait (TIG) tests, ADC stadiation, Mood score, number of years of education and history of alcohol or drug abuse. Ordered categorical data (DSY, TIG and MMS) were analysed using the Multiple Proportional Odds regression model (McCullagh), while Mood was analysed using a multiple logistic regression model. RESULTS: Of the 412 patients 90 (22%) were AIDS at baseline, 120 (29%) were females, 243 (59%) were IVDU and 71 (17%) were homosexuals. A total of 61 (15%) admitted being alcoholics while 110 (27%) were classified as being in some state of affective disorder. The analysis of the age-adjusted scores for DSY showed that patients with higher literacy and greater CD4+ cell counts were more likely to have no deficit (p < 0.001), while IVDU's were likely to perform worse than homosexuals (p < 0.029). Multiple logistic regression on scores for TIG failed to identify any variable associated with performance. A multiple proportional odds regression analysis on scores for MMS showed that alcoholics tend to score less (p < 0.005) and subjects with a greater number of years of education and a larger CD4+ cell count tend to score more (p < 0.009 for both). Finally, Mood at study entry seems to be independently associated only with gender and AIDS condition, the chances of being depressed being 1.77 times greater for AIDS subjects vs. ARC and 1.63 times greater for females vs males. DISCUSSION: Our results show that specific and non-HIV related factors, namely, the number of years of education, drug and alcohol abuse, may affect performance in these tests. Considering that the diagnosis of ADC is predominantly clinical our study demonstrates that clinical and test assisted diagnoses of cognitive impairment may be biased when applied to patients with little schooling and/or a history of drug or alcohol abuse. DE Acquired Immunodeficiency Syndrome/*DIAGNOSIS/DRUG THERAPY/ PSYCHOLOGY Adult Alcoholism/COMPLICATIONS/PSYCHOLOGY AIDS Dementia Complex/*DIAGNOSIS/DRUG THERAPY/PSYCHOLOGY AIDS-Related Complex/*DIAGNOSIS/DRUG THERAPY/PSYCHOLOGY Comparative Study Didanosine/THERAPEUTIC USE Female Homosexuality Human Male Neuropsychological Tests/*STATISTICS & NUMER DATA Organic Mental Disorders, Substance-Induced/DIAGNOSIS/PSYCHOLOGY Psychometrics Substance Abuse, Intravenous/COMPLICATIONS/PSYCHOLOGY 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).