Intervention Review

Adjunctive therapies for AIDS dementia complex

  1. Olalekan A Uthman1,*,
  2. Jubril O Abdulmalik2

Editorial Group: Cochrane HIV/AIDS Group

Published Online: 16 JUL 2008

Assessed as up-to-date: 11 FEB 2007

DOI: 10.1002/14651858.CD006496.pub2


How to Cite

Uthman OA, Abdulmalik JO. Adjunctive therapies for AIDS dementia complex. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD006496. DOI: 10.1002/14651858.CD006496.pub2.

Author Information

  1. 1

    Save the Youth Initiative, Ilorin, Kwara State, Nigeria

  2. 2

    Federal Neuropsychiatric Hospital, Maiduguri, Nigeria

*Olalekan A Uthman, Save the Youth Initiative, P. O. Box 5146, Ilorin, Kwara State, 240-001, Nigeria. uthlekan@yahoo.com.

Publication History

  1. Publication Status: New
  2. Published Online: 16 JUL 2008

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

AIDS dementia complex is a common complication of human immunodeficiency virus type 1 (HIV-1) that continues to exist despite the current use of potent antiretroviral therapy. It is a source of great morbidity and, when severe, is associated with limited survival.

Objectives

To determine efficacy and safety of adjunctive therapies for AIDS dementia complex

Search methods

We searched the Cochrane HIV/AIDS group trials Specialized Register (December 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2007), MEDLINE (January 1980 to February 2007), EMBASE (January 1980 to February 2007), AIDSearch (January 1980 to February 2007), PsycINFO (January 1980 to February 2007), PSYCHLIT (January 1980 to February 2007), LILACS (January 1980 to February 2007), conference proceedings, trial registers, theses databases, and reference lists of the articles. We also contacted manufacturers and researchers in the field.

Selection criteria

Randomized controlled trials, either published or published, that compared one type of adjunctive therapy to no therapy or placebo in adults with AIDS dementia complex

Data collection and analysis

Two authors independently assessed trials quality, extracted data and entered data into RevMan 4.2 software. Where possible intention-to-treat data were used and we contacted study authors for additional information. We collected neurocognitive performance, adverse effects, tolerability and all-cause mortality information from the trials.

Main results

Ten trials involving 711 people were included. All the studies were phase 2 trials. Six studies used adequate methods for allocation of sequence generation and unclear in the remaining four trials. Allocation concealment was adequate in five trials and unclear in the remaining trials. The trials were heterogeneous in terms of types, dosages, routes and frequencies of administration of the adjunctive therapies. There were no significant differences between the treated and placebo groups on neuropsychological test scores, number of those that complete the assign dosage of experimental medication, adverse effects, and all-cause mortality.

Authors' conclusions

This review confirms the absence of evidence that any of the adjunctive therapies improves cognitive performance or quality of life, or both for patients with ADC, though they were well tolerated and safe.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

There is no evidence that adjunctive therapies for AIDS dementia are effective, though they are well-tolerated and safe.

The authors did a systematic review of ten studies, to see if adjunctive therapies (supplemental to the main treatment) for AIDS dementia were effective and safe. They found no evidence that adjunctive therapies had any effect on the patients They did find adjunctive therapies to be safe, and without any harmful effect on the patients.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

愛滋病癡呆複合症狀(AIDS dementia comples)之附屬治療

愛滋病癡呆複合症狀在正在接受有效治療之第一類人類免疫缺乏病毒感染的病人是常見的併發症。愛滋病癡呆複合症狀會導致高罹病率,且在嚴重的病人上有高死亡率。

目標

為了要測試針對愛滋病癡呆複合症狀之附屬治療之效果與安全性。

搜尋策略

我們搜尋了Cochrane HIV/AIDS group trials Specialized Register (December 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2007), MEDLINE (January 1980 to February 2007), EMBASE (January 1980 to February 2007), AIDSearch (January 1980 to February 2007), PsycINFO (January 1980 to February 2007), PSYCHLIT (January 1980 to February 2007), LILACS (January 1980 to February 2007), 會議程序,臨床試驗登錄,資料庫,文章的引用出處。我們也聯絡了此領域的製造商與研究者。

選擇標準

隨機對照試驗,包含有發表或未發表,針對在使用附屬治療的愛滋病癡呆複合症狀之病人與未接受任何治療或是安慰劑的病人作比較。

資料收集與分析

2 位作者分別獨立評估試驗的品質,抽取資料並輸入RevMan 4.2 software。進行“意向分析”,並與各個試驗之作者聯繫獲取額外的資料。我們從各個試驗中收集了神經認知表現,藥物副作用,藥物耐受性及各種原因的死亡率。

主要結論

一共包含了10個試驗,711個受試者。所有的試驗都是第二階段之臨床試驗。其中6個試驗使用適當的分配順序,另外4個則沒交代清楚。其中5個試驗在分配時有做到適當的隱瞞,另外5個則沒交代清楚。各個試驗之間之附屬治療的種類,劑量,給藥途徑及頻率皆有差異。在治療組與對照組病人的神經心理測試之分數,接受完整實驗藥物劑量試驗的病人數,藥物副作用及各種原因之死亡率皆沒有顯著差異。

作者結論

這篇評論性文章確認了愛滋病癡呆複合症狀之病人接受附屬治療雖然耐受性高且安全,但是並不會改善其認知功能或生活品質。

翻譯人

本摘要由臺北榮民總醫院李昀璇翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

作者針對10篇臨床試驗做了系統性的研究分析,去評估附屬治療(在原治療上加上新的治療)對於愛滋病癡呆複合症狀的病人是否有效且安全。他們發現附屬治療對於這些病人並沒有證據的支持有效。但他們發現附屬治療是安全的,並不會對這些病人造成傷害。