NEUROPHYSIOLOGICAL EVALUATION OF ZIDOVUDINE IN ASYMPTOMATIC HIV-1 INFECTION - A LONGITUDINAL PLACEBO-CONTROLLED STUDY

The effect of early antiretroviral medication with zidovudine on neuro physiological functions was evaluated in subjects with asymptomatic HI V-1 infection. Patients were recruited participants of a larger double -blind randomised placebo-controlled treatment trial with zidovudine ( Concorde). The main outcome measures included: quantitative electroenc ephalography (QEEG), auditory event-related potentials (AEP) and patte rn-reversal. visual evoked potentials (PRVEP), as well as standard cli nical, virological and immunological markers. No significant impairmen t and no difference between treatment groups was found in visual P100 latency and auditory long-latency P3 responses which is in agreement w ith the absence of neurological and neuropsychological impairment over the study period. Significant treatment effects were revealed by quan titative electroencephalography (QEEG). While the placebo group showed a significant increase in delta and theta slow frequency QEEG activit y over the study period, slow wave amplitude remained unchanged in the zidovudine group after a mean follow-up period of 28 months. In summa ry, the data provide evidence for a low level neuropathological proces s in asymptomatic HIV-1 infection which can be effectively suppressed by antiretroviral medication.