HIV and the Brain: Highlights of the Seventh Neuroscience of HIV Infection Meeting

Read Mark Mascolini's full report in the June, 1996 Journal of the International Association of Physicians in AIDS Care.

Paris, for centuries a hotbed of cool reason, hosted a thought-provoking assembly of neurologists at the seventh Neuroscience of HIV Infection meeting on March 6-9. A report on the conference in the June issue of the Journal of the International Association of Physicians in AIDS Care, features the following highlights. The June issue also includes an interview with neurologist Justin C. McArthur of Johns Hopkins University, one of the plenary speakers at the Paris conference.

• Several key investigators concurred that the treatment of HIV-neurocognitive disorders should be three-pronged: Attack the virus. Attenuate the inflammation. Protect the neurons. So far, though, only the first prong--antiretroviral therapy--is hitting home.

• One neuron-protecting therapy, with a vitamin E-like antioxidant labeled OPC 14,117, passed muster in a 30-person placebo-controlled trial. There were trends toward improved memory and motor speed in cognitively impaired individuals who got the drug. But the study was too small to show significant improvements.

• Oxandrolone, an anabolic steroid being tested for AIDS-related wasting and myopathy, showed significant weight-sustaining activity in a small placebo-controlled study. But it did not improve muscle strength at a dose of 15 mg daily.

• A placebo-controlled trial of SNX-111, for relief of severe pain, is recruiting 150 individuals with cancer or AIDS after pilot studies demonstrated this synthetic peptide's effect in some people with irremediable pain.
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• In an interview with the Journal, Justin McArthur said that a trial of nerve growth factor for neuropathic pain is just getting started. Current treatments for neuropathy are symptomatic, he pointed out, but nerve growth factor may be restorative.

• Two groups detailed evidence that a syndrome called minor cognitive motor disorder precedes frank dementia in people with HIV and is a harbinger of AIDS and shortened survival.

• Two Italian studies suggested that PCR of cerebrospinal fluid may be an accurate and minimally invasive diagnostic procedure for several HIV-associated neurologic conditions.

• The details of HIV neuropathogenesis continue to elude researchers. But Leon Epstein of the University of Rochester noted that effective therapy does not depend on a total understanding of pathogenesis. Clues that emerge from ongoing study can point to potential remedies.

©1996, Medical Publications Corporation