Brew BJ; Australasian Society for HIV Medicine. Conference.
Annu Conf Australas Soc HIV Med. 1994 Nov 3-6; 6: 71 (unnumbered abstract).
St Vincent's Hospital, Darlinghurst, NSW.
AIDS dementia complex (ADC) is a predominantly subcortical dementia that occurs in approximately 20% of patients with advanced HIV disease. In a personally examined series, the mean CD4 count was found to be 94/1 +/- 38. The commonest symptoms were difficulty with concentration and short term memory accompanied by gait unsteadiness and less often social apathy. Some of these manifestations may be confused with psychiatric symptomatology but often there were other complaints such as urinary hesitancy, frequency and limb tremor that clearly defined the organic basis of the disorder. Complaints of gait unsteadiness and limb clumsiness were highly associated with underlying ADC. Difficulties with concentration, social apathy and tremor were highly predictive in otherwise asymptomatic patients of the subsequent development of ADC at 12 months whilst complaints of short term memory were predictive of ADC at 3 and 6 months and seizures were predictive at 3 months. The mean time to progression from stage 0.5, that is minor symptoms without the presence of dementia, to stage 1 or more was 59 weeks. Investigation of a patient with ADC is largely exclusionary by means of CT brain scan and CSF analysis. In the appropriate patient the following findings are confirmatory: CT brain scan showing cerebral atrophy and elevated concentrations of CSF beta 2 microglobulin and neopterin. Treatment consists of zidovudine which on average can be expected to work in 50% of patients. The mean time for response is 8 weeks. Newer forms of treatment include atevirdine for which data will be presented later in this conference and more experimental therapies such as delavirdine and peptide T.
Publication Types:
Keywords:
- AIDS Dementia Complex
- Acquired Immunodeficiency Syndrome
- CD4 Lymphocyte Count
- Disease Progression
- HIV Infections
- HIV Seropositivity
- Humans
- Neopterin
- Peptide T
- Tomography, X-Ray Computed
- Zidovudine
- beta 2-Microglobulin
- radiography
Other ID:
UI: 102212432
From Meeting Abstracts