Protease inhibitors may help stop -- and even reverse -- AIDS dementia, according to Dr. Christopher Filippi of New York City's Albert Einstein College of Medicine. Citing his study of 16 end-stage PWAs -- nine on protease inhibitors and seven not -- Filippi said that protease-based combinations "reversed dementia in some cases, and that's never been shown before." Of the nine on protease, all but one had a reduction in dementia; four stabilized to near normal. Several patients who had been nurse-dependent even went back to work, Filippi said.
The patients not on protease? "They got more demented," Filippi said. "The brain scans got much worse and over the next six months almost all of them died." Dr. Richard Price, professor of neurology at the University of California San Francisco, trumpeted his colleague's work. "Most people interested in AIDS dementia have the sense that antiretroviral therapy does help these patients," he said. "The only issue is which combinations are most effective." The number of dementia cases is apt to decrease with time, Filippi predicted, since most PWAs are now routinely started on protease inhibitors. But, he pointed out, many who live in rural regions do not have access to the drugs.