Ammassari A, Cinque P, Lorenzini P, Cingolani A, Giancola ML, Bossolasco S, Govoni A, Finazzi MG, Grosso BD, Bongiovanni M, Vigo B, Moretti F, Gentile M, Monno L, Dallenogare ER, Corsi P, Guaraldi G, Arcidiacono MI, Mastroianni A, Zannoni P, Antinori A; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. ThPeB7370.

Clinic Infectious Diseases, Catholic University, Roma, Italy

BACKGROUND: HIV-related CNS diseases may be changed by HAART, though this needs to be studied more in detail. Objective of the study was to evaluate frequency, characteristics, and relationship with antiretrovirals of CNS diseases in the HAART era. METHODS: Prospective study conducted in 65 Italian HIV/AIDS centers from 1.1.2000. Characteristics of CNS diagnoses, HIV and HAART histories are collected. RESULTS: At 31.12.2001, 580 pts enrolled: 51% HAART-experienced. Median age 39 y; 73% males; 44% IDU, 11% MSM, 32% heterosex; 35% AIDS. Median CD4 and plasma VL were 58/l (IQR 21-146) and 4.89 log10 c/ml (3.82-5.43). Main diagnoses: 31% TE, 18% HIVE, 15% PML, 11% crypto, 4% PCNSL, 3% TB, 2% CMV. In 10% an encephalopathy of unknown origin (EUO) was observed. An opposite association was found between HAART exposure and HIVE (OR 0.56;0.36-0.86) or EUO (4.31;2.18-8.54) as well as between >3 BBB crossing drugs and HIVE (0.49;0.26-0.97) or EUO (2.09;1.12-3.91). CD4>200+VL<500 significantly reduce probability of TE (0.45;0.29-0.69), HSV (0.29;0.25-0.33) and crypto (0.28;0.13-0.64), but increase EUO (2.09;1.87-3.72). Variables independently associated with TE were: heterosex (2.28;1.26-4.14), CD4>200 (0.44;0.20-0.97), contrast enhancement (CE) (9.14;4.62-18.0), mass effect (ME) (3.54;1.99-6.27); PML: focal lesion (3.41;1.97-5.87), ME (0.01;0.02-0.10); PCNSL: ME (3.87;1.41-10.6); HIVE: AIDS (0.38;0.19-0.77), cognitive signs (8.32;3.12-22.3), focal signs (0.26,0.14-0.49), atrophy (2.03-7.23), focal lesion (0.23;0.12-0.54), CE (0.26;0.09-0.75); EUO: HAART exposure (5.00;2.07-12.00), cognitive signs (0.27;0.09-0.72); white matter involvement (3.47;1.19-10.0). CONCLUSIONS: Also in the HAART era CNS disorders determine a relevant morbidity. HAART-experienced pts, particularly those on drugs effective in the CNS and with viroimmunologic response, develop less HIVE, but are at higher risk of a leucoencephalopathy of unknown origin.

Publication Types:

• Meeting Abstracts

Keywords:

• Accidents
• Acquired Immunodeficiency Syndrome
• Antiretroviral Therapy, Highly Active
• HIV Infections
• HIV Seropositivity
• Humans
• Male
• Nervous System Diseases
• Prospective Studies
• Registries
• injuries

Other ID:

• GWAIDS0019871

UI: 102258858

From Meeting Abstracts