Objectives: To determine the efficacy of the non-nucleoside reverse transcriptase inhibitor atevirdine in the treatment of AIDS dementia complex (ADC).
Design: Open label pilot study.
Methods: Ten patients with ADC (stage 1 or 2) who were intolerant to zidovudine or dideoxyinosine, or in whom the antiretrovirals had failed to prevent further decline in CD4 cell levels, were entered into the study. Atevirdine, 1800 mg daily in three divided doses, was given over a 12-week period. Patients were assessed neurologically and neuropsychologically every 4 weeks. Cerebrospinal fluid analysis was performed at entry and at weeks 4 and 12. Technetium-99 exametazine single photon emission computed tomographic cerebral perfusion scans and magnetic resonance imaging brain scans were performed at weeks 0 and 12.
Results: Five patients completed the 12 week protocol. Four of these five responded to atevirdine, as judged by quantified neurological and neuropsychological assessments. Atevirdine was well tolerated apart from the development of rash, anxiety, intermittent diarrhoea and fatigue.
Conclusions: These preliminary results suggest that atevirdine is efficacious in the treatment of ADC. Larger blinded studies of this class of drug in the treatment of ADC are required.