       Document 0233
 DOCN  M9630233
 TI    Changing incidence of HIV-induced brain lesions in Oslo, 1983-1994:
       effects of zidovudine treatment.
 DT    9603
 AU    Maehlen J; Dunlop O; Liestol K; Dobloug JH; Goplen AK; Torvik A;
       Department of Pathology, Ulleval University Hospital, Oslo,; Norway.
 SO    AIDS. 1995 Oct;9(10):1165-9. Unique Identifier : AIDSLINE MED/96098133
 AB    OBJECTIVE: To investigate the relation between HIV-induced brain
       lesions, zidovudine (ZDV) treatment and survival length in a
       well-defined population of HIV-positive patients. METHODS AND PATIENTS:
       Ulleval Hospital has the responsibility for treating all AIDS patients
       from the city of Oslo except haemophiliac patients. The patient
       population in this autopsy study comprised all adult AIDS patients in
       Oslo who were treated at our hospital and died during 1983-1994 (n =
       171). This represents 86% of all adult AIDS patients from Oslo who died
       during the same period. Full autopsy, including neuropathological
       examination of the brain and spinal cord, was performed on 128 (75%) of
       those who died. RESULTS: No significant differences were found between
       autopsy and non-autopsy cases with regard to sex, age, risk groups,
       survival length or ZDV treatment. In the autopsy material,
       multinucleated giant cells (MGC) in brain tissue were found in 29 cases
       and diffuse damage of white matter in 52 cases. Analysis shows that ZDV
       (600 mg per day) reduced the incidence of these brain lesions, but only
       if continued until death. A second finding was an increased incidence of
       HIV-induced brain lesions for those with long-term survival. Together
       these observations may explain a substantial part of the time-trend in
       the incidence of MGC in Oslo. MGC were frequent (40%) during the first
       years of the epidemic, although survival length was short in this
       period. The incidence fell markedly around the time ZDV was introduced
       and later remained low in those using ZDV until death. The incidence of
       MGC has, however, increased during the later years, the new cases mainly
       occurring in patients who had discontinued ZDV use. CONCLUSION: If
       continued until death, ZDV can reduce the incidence of HIV-induced brain
       lesions in AIDS patients. When ZDV treatment is terminated a rapid
       increase occurs in the incidence of HIV encephalitis.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS/*DRUG THERAPY/
       MORTALITY  Adult  Aged  Antiviral Agents/*THERAPEUTIC USE
       Brain/*PATHOLOGY  Brain Diseases/ETIOLOGY/PATHOLOGY  Cytopathogenic
       Effect, Viral  Encephalitis, Viral/MORTALITY/PREVENTION & CONTROL
       Female  Giant Cells/DRUG EFFECTS/*PATHOLOGY  Human  Male  Middle Age
       Norway  Regression Analysis  Support, Non-U.S. Gov't  Survival Rate
       Zidovudine/*THERAPEUTIC USE  CLINICAL TRIAL  JOURNAL ARTICLE

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

