Survival after diagnosis with AIDS-related neurological illnesses has improved since the advent of HAART, according to an abstract presented to the eleventh European AIDS Conference (EACS). Furthermore, patients on ARV regimens containing a higher number of drugs that crossed the ‘blood-brain barrier’ and got into the central nervous system (CNS) had better survival rates. However the study also found that survival from two conditions – cryptococcal meningitis and progressive multifocal leukoencephalopathy (PML) - has not improved since the early days of HAART, and in the case of PML has got slightly worse since 1998.
Amongst the most feared symptoms of AIDS are those that affect the brain. However an analysis of data from the French Hospital Database of HIV, a large cohort study of HIV patients conducted by he French INSERM research institute presented to the conference that survival rates from four of them – toxoplasmosis, dementia resulting from HIV encephalopathy, PML and cryptococcal meningitis – had improved dramatically since the advent of HAART.
In the pre-HAART era, less than half of patients diagnosed with any of these conditions were expected to be alive a year later, and in the case of AIDS dementia and PML that fell to one in five. Survival rates immediately improved when HAART came along. One year survival rates for the four conditions were 73 percent, 55 percent, 56 percent and 76 percent between 1996 and 1998. Since then survival from toxoplasmosis and HIV dementia have continued to improve and one-year survival now stood at 80 percent and 70 percent respectively for the two conditions.
Survival with AIDS-related meningitis had improved non-significantly and was now at 86 percent. But survival with PML had actually got marginally worse and now stood at 49 percent.