One of the many nasty things HIV does to the body is interfere with the brain and nervous system. Some drugs used in highly active antiretroviral therapy (HAART) are better than others at gettting into the nervous system; researchers in Sydney, Australia, looked at how helpful it is to take more neuroactive drugs.

What the researchers wanted to know: Does including neuroactive drugs in HAART improve neurological and psychological symptoms?

What they did: Ninety-six men and one woman with HIV who attended the outpatient clinics at St. Vincent's Hospital in Sydney took part in the study. All were on a HAART drug combination—a drug cocktail that included three or more of 18 antiretroviral drugs. All were clinically stable but with fairly advanced infections. None had a neurologic disease, such as AIDS dementia or an infection of the central nervous system, when the study started. The researchers used recruited 30 HIV-negative men, as controls. Of the HIV-positive men, 41 were on a neurologically active HAART regimen, which meant that at least three of their drugs were known to be good at penetrating the central nervous system. All of the men took a standard set of tests that cover areas including attention, motor coordination, and memory.

What they found: For most tests, HIV-positive people did worse than the HIV-negative men, but there were no significant differences between the HIV-positive people who were on neuroactive regimens and those who weren't. The researchers also looked at people who had significant neuropsychological impairment. Among those people, the neuroactive HAART patients did better on verbal memory tests than the non-neuractive patients.

What the study means to you: This suggests that including neuroactive drugs in the antiretroviral cocktail might help some people. The researchers say this is not definitive, since it included only a few patients, but it's worth more research.

Caveats: The study was small. Also, people couldn't be assigned to take one drug regimen or another.

Find out more: HIV and AIDS information from the University of California–San Francisco

A page on World AIDS Day, Dec. 1, 2004, from the Kaiser Family Foundation

Read the article: Cysique, L.A.J., et al. "Antiretroviral Therapy in HIV Infection: Are Neurologically Active Drugs Important?" Archives of Neurology. November 2004, Vol. 61, pp. 1699-1704.

Abstract online: http://archneur.ama-assn.org