HAART is neuroprophylactic in HIV-1 infection

Background: To find out about the prophylactic value of antiretroviral ther apy on HIV-l-associated subclinical and clinical psychomotor slowing as one marker of HIV-1-associated CNS disease. Methods: Prospective study with regular clinical and neurophysiologic exami nation every three months of 1482 consecutive HIV-1-seropositive and AIDS p atients seen at our department till June 30, 1999. Results: Antiretroviral therapy has a significant prophylactic value over a n individual observation period of ten years with regard to the first, pote ntially transient manifestation of HIV-l-associated subclinical psychomotor slowing and with regard to the clinical manifestation of motor signs. Howe ver, a subgroup of patients is characterized through a second, more sustain ed manifestation of subclinical psychomotor slowing which cannot be prevent ed by any type of currently available antiretroviral therapy. Conclusions: These findings suggest the existence of different pathomechani sms underlying HIV-l-associated brain disease which may in part be effectiv ely prevented, but which in part also escape all antiretroviral treatment s trategies in use today.