Document 0325
 DOCN  M9590325
 TI    The frequency of HIV-associated dementia complex in patients with CD4
       cell counts less than 250mm-3.
 DT    9509
 AU    Wright E; Maruff P; Malone V; Tyler P; Hoy J; Brew B; Currie J;
       Fairfield Infectious Diseases Hospital, Mental Health Research;
       Institute of Victoria.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:175 (unnumbered
       abstract). Unique Identifier : AIDSLINE ASHM6/95291774
 AB    OBJECTIVE: To investigate (1) HIV-1 associated dementia complex (HDC) in
       HIV infected patients with CD4 cell counts < 250mm-3 who have not
       received didanosine and (2) the frequency with which HDC is the
       AIDS-defining illness (ADI) in this patient population. METHODS:
       Patients were recruited through large metropolitan hospital inpatient
       and outpatient departments, general practitioners' clinics and from the
       general community. All patients underwent neurocognitive and psychiatric
       assessment and case records and laboratory test results were also
       reviewed. Abnormalities were rated using the Price-Brew HDC staging
       scheme where a rating of stage 1 or greater indicates possible HDC.
       RESULTS: Between October 1993 and June 1994 61 patients were assessed
       and of these, 20 (33%) had cognitive changes suggestive of HDC (12 stage
       1; 8 stage 2). There were no significant differences between patients
       with or without possible HDC for age, education, patterns of alcohol and
       drug use and antiretroviral use, but CD4 count was significantly lower
       in the patients with possible HDC. In 10 (50%) of the 20 HDC patients,
       recognition of HDC was the ADI. CD4 cell counts for patients with no
       prior ADIs (median 144, range 10-273) were significantly higher than for
       patients with a prior ADI (median 15, range 5-250; p < 0.05). Patients
       with stage 2 HDC had significantly lower CD4 cell counts (P < 0.001) and
       lower haemoglobin levels (p < 0.006) than those with stage 1 HDC.
       CONCLUSION: In up to 50% of HDC cases, the identification of HDC may be
       the AIDS defining illness.
 DE    Acquired Immunodeficiency Syndrome/CLASSIFICATION/*DIAGNOSIS/
       IMMUNOLOGY  AIDS Dementia Complex/CLASSIFICATION/*DIAGNOSIS/IMMUNOLOGY
       *CD4 Lymphocyte Count  Human  *HIV-1  Neuropsychological Tests
       Predictive Value of Tests  MEETING ABSTRACT

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