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| |  Drug Combinations Decrease Risk Of AIDS-Related Dementia LONDON, ENGLAND -- May 22, 1998 -- HIV-1 disease involves the central nervous system shortly after infection. The viral RNA replicates in the cerebrospinal fluid and can eventually lead to a form of dementia called AIDS dementia complex. Zidovudine previously has been shown to decrease the number of cases of AIDS dementia complex. Dr Norbert Foudraine and colleagues from the Netherlands investigated how well two combinations of drugs penetrated the cerebrospinal fluid, in which the RNA replicates and how the drugs affected the numbers of copies of RNA present. Their research is presented in this week’s issue of The Lancet. The investigators included 28 patients who had never taken antiretroviral drugs and who had no neurological symptoms in their study. At the start of the study, blood samples were taken and lumbar punctures were done to find out the number of RNA copies in the plasma and cerebrospinal fluid. All patients had detectable numbers of copies. The patients were given either a combination of lamivudine and stavudine, or of lamivudine and zidovudine. After 12 weeks of treatment, the investigators measured the plasma and cerebrospinal fluid concentrations of HIV-1 RNA copies. They found that the two combinations of drugs had similarly decreased the number of copies so that they were no longer detectable. The investigators also found that although the drug concentrations decreased in the plasma quite quickly, they were consistent in the cerebrospinal fluid for longer. "These results suggest that antiretroviral drugs other than zidovudine can inhibit replication in the central nervous system", they write, adding this is important for patients who cannot take zidovudine.
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