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AIDS Drugs May Protect Brain
Date:10/11/2007

Study found levels of protein indicating damage returned to normal in many HIV patients

THURSDAY, Oct. 11 (HealthDay News) -- Preliminary research suggests that potent AIDS drugs might stop the brain damage that afflicts many people infected with HIV.

The findings are based upon measurements of a brain protein, not extensive cognitive testing, so it's not clear exactly what they mean for thinking processes in patients. Still, the research is promising, said study author Dr. Asa Mellgren, a researcher with the Clinic of Infectious Diseases SAS and Sahlgrenska Academy in Sweden. The finding is published in the Oct. 9 issue of Neurology.

"In a few patients followed for 10 years, we did not see signs that HIV will do any more damage as long as the patient stays on an effective [drug] treatment," Mellgren said.

While it doesn't get a lot of attention, it's not uncommon for AIDS patients to develop brain damage and lose their ability to think clearly, explained Dr. Stuart Lipton, a neurologist with the Burnham Institute for Medical Research and the University of California at San Diego.

In fact, AIDS is the leading cause of dementia in people under the age of 40, Lipton said.

The good news is that the brain damage seems to have become less severe over the past decade, thanks to a new generation of powerful AIDS drugs. "We see a lot more cases of what we call minimal cognitive impairment," Lipton said, causing people to have trouble concentrating.

"It's not this raging dementia anymore," he said. "But it keeps you from working and doing your daily activities, so it's still a problem."

In the new study, researchers examined levels of a protein in 53 HIV patients who began treatment with drugs known as highly active antiretrovirals. This so-called "cocktail" of drugs is considered the best treatment for HIV.

Using spinal taps before and after the men and the women began treatment, the researchers found that levels of the so-called "neurofilament light protein" went down. Levels of the protein are considered to be an indicator of disease that causes the brain to degenerate.

Of the patients, 21 had high levels of the protein at the beginning of the study, suggesting they may have had brain damage. But the levels in about half of them dropped to normal levels after they took AIDS drugs for three months. After one year, only four people still had high levels of the protein.

"It is now possible to measure if the patients have signs of brain damage due to HIV by making a spinal tap, and it is also possible to monitor the changes of this marker during [treatment]," Mellgren said.

It is important to find markers that can indicate what's going on in the brain, said Lipton. However, cognitive tests are still needed to understand fully how a patient is doing, he said.

The study authors acknowledged that future research needs to include more extensive cognitive testing.

More information

Learn more about HIV from the U.S. Centers for Disease Control and Prevention.



SOURCES: Asa Mellgren, M.D., Ph.D., researcher, Clinic of Infectious Diseases SAS, Boras, and Sahlgrenska Academy, Goteborg University, Goteborg, Sweden; Stuart Lipton, M.D., neurologist and researcher, Burnham Institute for Medical Research and University of California at San Diego; Oct. 9, 2007, Neurology


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