       Document 2930
 DOCN  M94A2930
 TI    HIV independent factors influencing neuropsychological performance in
       ARC and AIDS individuals.
 DT    9412
 AU    Dally LG; Chiesi A; Tomino C; Floridia M; Seeber A; Vella S; ISS, Lab.
       of Virology, Rome, Italy.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):192 (abstract no. PB0198). Unique
       Identifier : AIDSLINE ICA10/94369645
 AB    INTRODUCTION: Our previous studies on the epidemiology of ADC in Italy
       (16813 pts. diagnosed between August 1987 and December 1993) showed that
       ADC, as the first AIDS defining disease, occurred in 9.1% IVDU's vs 5.2%
       homosexuals, the two groups being similar for mean CD4+ cell count. This
       finding rose the question of which factors could account for the higher
       incidence of ADC in the IVDU population. OBJECTIVE: To investigate the
       possible role of HIV independent factors in influencing
       neuropsychological performance and thus, indirectly, the diagnosis of
       AIDS dementia complex (ADC). METHODS: We analyzed data on 412 patients
       enrolled between Oct. 1990 and Dec. 1992 in two AZT vs DDI randomized,
       multicenter trials. The present analysis is of baseline data only.
       Together with clinical and haematoimmunological data, baseline
       information included score for Mini-Mental Status (MMS), Digit Symbol
       (DSY) and Timed Gait (TIG) tests, ADC stadiation, Mood score, number of
       years of education and history of alcohol or drug abuse. Ordered
       categorical data (DSY, TIG and MMS) were analysed using the Multiple
       Proportional Odds regression model (McCullagh), while Mood was analysed
       using a multiple logistic regression model. RESULTS: Of the 412 patients
       90 (22%) were AIDS at baseline, 120 (29%) were females, 243 (59%) were
       IVDU and 71 (17%) were homosexuals. A total of 61 (15%) admitted being
       alcoholics while 110 (27%) were classified as being in some state of
       affective disorder. The analysis of the age-adjusted scores for DSY
       showed that patients with higher literacy and greater CD4+ cell counts
       were more likely to have no deficit (p < 0.001), while IVDU's were
       likely to perform worse than homosexuals (p < 0.029). Multiple logistic
       regression on scores for TIG failed to identify any variable associated
       with performance. A multiple proportional odds regression analysis on
       scores for MMS showed that alcoholics tend to score less (p < 0.005) and
       subjects with a greater number of years of education and a larger CD4+
       cell count tend to score more (p < 0.009 for both). Finally, Mood at
       study entry seems to be independently associated only with gender and
       AIDS condition, the chances of being depressed being 1.77 times greater
       for AIDS subjects vs. ARC and 1.63 times greater for females vs males.
       DISCUSSION: Our results show that specific and non-HIV related factors,
       namely, the number of years of education, drug and alcohol abuse, may
       affect performance in these tests. Considering that the diagnosis of ADC
       is predominantly clinical our study demonstrates that clinical and test
       assisted diagnoses of cognitive impairment may be biased when applied to
       patients with little schooling and/or a history of drug or alcohol
       abuse.
 DE    Acquired Immunodeficiency Syndrome/*DIAGNOSIS/DRUG THERAPY/  PSYCHOLOGY
       Adult  Alcoholism/COMPLICATIONS/PSYCHOLOGY  AIDS Dementia
       Complex/*DIAGNOSIS/DRUG THERAPY/PSYCHOLOGY  AIDS-Related
       Complex/*DIAGNOSIS/DRUG THERAPY/PSYCHOLOGY  Comparative Study
       Didanosine/THERAPEUTIC USE  Female  Homosexuality  Human  Male
       Neuropsychological Tests/*STATISTICS & NUMER DATA  Organic Mental
       Disorders, Substance-Induced/DIAGNOSIS/PSYCHOLOGY  Psychometrics
       Substance Abuse, Intravenous/COMPLICATIONS/PSYCHOLOGY
       Zidovudine/THERAPEUTIC USE  CLINICAL TRIAL  MEETING ABSTRACT
       MULTICENTER STUDY  RANDOMIZED CONTROLLED TRIAL

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

