       Document 0449
 DOCN  M9640449
 TI    Epidemiology of AIDS dementia complex in Europe. AIDS in Europe Study
       Group.
 DT    9604
 AU    Chiesi A; Vella S; Dally LG; Pedersen C; Danner S; Johnson AM; Schwander
       S; Goebel FD; Glauser M; Antunes F; et al; Instituto Superiore di
       Sanita, Laboratory of Virology, Rome,; Italy.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jan 1;11(1):39-44.
       Unique Identifier : AIDSLINE MED/96130045
 AB    The aim of the study was to describe the epidemiology of AIDS dementia
       complex (ADC) in Europe and to assess the possible role of zidovudine
       therapy in preventing or delaying its occurrence. We used an inception
       cohort, with data collected retrospectively from patients' clinical
       records from 52 clinical centers in 17 countries across Europe. The
       subjects were 6,548 adult people with AIDS consecutively diagnosed from
       1979 to 1989. The main outcome measures were codiagnosis of ADC at the
       time of AIDS diagnosis and ADC-free time after AIDS diagnosis. ADC was
       reported in 295 patients (4.5%) at the time of AIDS diagnosis and during
       follow-up in a further 402 of the 5,160 patients (7.8%) who were
       diagnosed with AIDS based on diseases other than ADC. Whether at the
       time of AIDS diagnosis or later, the occurrence of ADC was significantly
       associated with age, transmission category, and CD4+ cell counts. The
       risk was greater in older patients (14 and 19% greater, at AIDS
       diagnosis and after, respectively, for a 5-year difference in age), in
       i.v. drug users than in homosexual and bisexual men (89 and 60% greater,
       at AIDS diagnosis and after, respectively), and for people with lower
       CD4+ cell counts (14 and 30% greater for a reduction of 1 on the natural
       log scale). Risk was almost double for women than for men. A significant
       reduction, of approximately 40%, was found in the risk of developing ADC
       after AIDS diagnosis for patients receiving zidovudine therapy, but this
       effect was present only during the first 18 months of treatment,
       irrespective of whether treatment began before or after AIDS diagnosis.
       In conclusion, an increase in the risk of developing ADC either at the
       time of AIDS diagnosis or thereafter is associated with increasing age,
       i.v. drug use, and decreased CD4+ cell count. Women tend to have a
       higher risk of ADC at the time of AIDS diagnosis. Zidovudine therapy
       appears to have a definite, but time-limited, effect of protecting
       patients against ADC development after AIDS diagnosis.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/DRUG THERAPY  Adult
       Antiviral Agents/THERAPEUTIC USE  AIDS Dementia
       Complex/DIAGNOSIS/*EPIDEMIOLOGY/PREVENTION &  CONTROL  Cohort Studies
       CD4 Lymphocyte Count  Europe/EPIDEMIOLOGY  Female  Human  *HIV-1
       Incidence  Male  Retrospective Studies  Risk Factors  Support, Non-U.S.
       Gov't  Survival Rate  Zidovudine/THERAPEUTIC USE  JOURNAL ARTICLE
       MULTICENTER STUDY

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

