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Therapeutic Effects of Nonnucleoside Reverse Transcriptase Inhibitors on the Central Nervous System in HIV-1-Infected Patients

von Giesen Hans Jürgen; Köller, Hubertus; Theisen, Albert; Arendt, Gabriele
JAIDS Journal of Acquired Immune Deficiency Syndromes: April 1st, 2002
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Summary:Psychomotor slowing predicts the development of HIV-1-associated dementia, AIDS, and death independent of immune status. We retrospectively selected all patients who showed pathologic psychomotor slowing as a sign of central nervous system (CNS) dysfunction before the onset of therapy and who were then treated with nonnucleoside reverse-transcriptase inhibitors—either efavirenz (EFV) (n = 65 patients) or nevirapine (NVP) (n = 39 patients), each given in combination with two nucleoside analogues (NAs). Patients who were treated only with two NAs (n = 66) served as controls. Patients were observed for 6 months. Both EFV and NVP combinations improved CNS function as determined by electrophysiologic motor tests. The therapeutic effects of EFV and NVP did not depend on the type of NA added. Although results did not reach significance, NVP combinations were more effective than EFV combinations or therapy regimens with NAs alone in patients who were naive to all antiretroviral therapy. EFV and NVP combinations were equally effective in patients pretreated with highly active antiretroviral therapy, including protease inhibitors.

Address correspondence and reprint requests to Hans-Jürgen von Giesen, Department of Neurology. Heinrich Heine University Düsseldorf, Postfach 10 10 07, D-40001 Düsseldorf, Germany; e-mail:

Manuscript received August 8, 2001; accepted November 29, 2001.

© 2002 Lippincott Williams & Wilkins, Inc.