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For Release After 9:30 a.m. CST, Tuesday, Dec. 2, 1997

RADIOLOGY EXAM SHOWS NEW DRUGS CAN REVERSE AIDS DEMENTIA

CHICAGO -- An important radiological study shows for the first time that the new protease inhibitor drugs for AIDS not only can halt the progression of brain disease caused by the HIV virus as seen on brain scans, but in some cases may reverse it.

Results of a magnetic resonance (MR) imaging study of the effects of protease inhibitors on patients with HIV-encephalopathy -- a disease of the white matter of the brain that can cause loss of mental and motor function -- were presented here today during the 83rd Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).

"Until now, HIV-encephalopathy has been considered to be relentlessly progressive. This is the first study that demonstrates clinical neurologic improvement with the use of protease inhibitors that correlates with an improvement seen on brain MR scans," said Christopher G. Filippi, M.D., assistant professor of radiology and director of neuroradiology at the Weiler Hospital, Albert Einstein College of Medicine, New York City.

Sixteen patients were studied. The MR scans of 8 of 9 patients (89 percent) who took protease inhibitors showed stabilization (4 patients) or near complete regression (4 patients) of white matter disease. These changes correlated with clinical improvements in their symptoms. One patient showed slight progression of disease. The MR scans of 6 of 7 patients (86 percent) not on protease inhibitors showed disease progression. These findings corresponded with decline in mental function. One patient showed no change. The study was conducted at Yale-New Haven Medical Center, New Haven, Conn.

Our study showed a statistically significant improvement with protease inhibitors and suggests that many more patients may benefit from these drugs," he said. Control of the disease with protease inhibitors also may avoid even more costly medical interventions, Dr. Filippi said.

Patients in the study were endstage AIDS patients with abnormal MR scans that showed a significant amount of white matter disease, Dr. Filippi said. In HIV-encephalopathy, the HIV virus invades the brain. All of the patients (9 men and 7 women) also were on nucleoside analogue therapy, such as zidovudine (AZT). Nine patients were started on protease inhibitor therapy (ritonavir, indinavir or saquinavir) by their primary care providers after an initial MR scan. The 7 patients in the control group were not given protease inhibitors for clinical reasons, ranging from elevated liver function tests to a history of non-compliance with medication regimens, according to Dr. Filippi. MR scans were performed at intervals ranging from 2 to 12 months, he said.

"Our results suggest that protease inhibitors in combination with drugs like AZT may be particularly effective because the two types of drugs target the HIV virus at different phases in its life cycle," he said.

Co-authors of a paper on the topic presented by Dr. Filippi during the RSNA meeting are G. Sze, M.D.; M. Shahmanesh, M.A., M.B., Bchir.; S. Farber, J.D.; and P. Selwyn, M.D., M.P.H.

The RSNA is an association of 30,000 radiologists and physicists in medicine dedicated to education and research in the science of radiology. The Society's headquarters are located at 2021 Spring Road, Suite 600, Oak Brook, Illinois 60523-1860.

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Copies of 1997 RSNA news releases are available online at http://www.pcipr.com/rsna beginning Monday, Dec. 1.