Reduced frequency of HIV-induced brain lesions in AIDS patients treated with zidovudine.

We evaluated the effect of zidovudine on HIV-induced lesions of the brain by comparing the neuropathological findings in 82 treated and 120 untreated patients who died from AIDS. We observed a statistically significant reduction of the number of cases with multinucleated giant cells (MGCs) in the brain and MGC-associated neuropathological damage in patients treated with zidovudine. The effects of zidovudine were time and dose related in the first 12 months of treatment, while longer periods of therapy produced no further results. The antiretroviral treatment particularly affected the frequency of diffuse demyelinating lesions of the cerebral white matter. In the patients who died with HIV-induced brain lesions but no other opportunistic brain diseases, the percentage of cases with clinical history of severe dementia was significantly lower in the group treated with zidovudine.