Long-term zidovudine reduces neurocognitive deficits in HIV-1 infection.
OBJECTIVE
To determine the efficacy of zidovudine (ZDV) in preventing decline of neurocognitive functions in HIV-1 infection.


METHODS
Retrospective evaluation of subjects enrolled in a natural history study. Two analyses were made to evaluate the effect of (1) current ZDV, irrespective of length of treatment and (2) long-term ZDV treatment for at least 1 year.


METHODS
Subjects were recruited from HIV out-patient clinics.


METHODS
HIV-1-seropositive subjects were assigned to one of three groups according to the Centers for Disease Control and Prevention classification: asymptomatic infection (n = 60), symptomatic infection but without AIDS (n = 51), and AIDS (n = 32).


METHODS
Standardized neuropsychological and neurophysiological measures [electroencephalogram (EEG) and long-latency evoked potentials].


RESULTS
Long-term ZDV use was associated with improved cognitive performance in subjects with early symptomatic HIV-1 infection and AIDS, compared to subjects in the same clinical stage but without previous ZDV treatment. This was corroborated by neurophysiological evidence of reduced slow-wave EEG amplitude in the ZDV-treated subjects. The advantage of ZDV treatment was evident despite lower immune status in most treated subjects.


CONCLUSIONS
The findings in this natural history study indicate that long-term ZDV treatment may be an effective prophylactic to reduce neurocognitive deficits in symptomatic HIV-1 infection, thereby lowering the risk for developing HIV-1-associated dementia.
Baldeweg
T
T
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, London, UK.
Catalan
J
J
Lovett
E
E
Gruzelier
J
J
Riccio
M
M
Hawkins
D
D
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D004569:Electroencephalography; D005072:Evoked Potentials, Auditory / Q000187:drug effects; D015497:HIV-1; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D013997:Time Factors; D015215:Zidovudine / Q000627:therapeutic use*
D015215:Zidovudine