[Aids: is it a risk factor in cerebrovascular disease?]

Cerebrovascular disease (CVD) has become an important health problem throughout the world. It is generally one the main causes of morbidity and mortality in the world, especially in developed countries. In these countries the frequency with which it appears is linked with the progress reached in the organisation of the public health system and the higher economic and social standards of their populations, which have given rise to prolonged life expectancy and a greater number of elderly people. In poor countries, however, in recent times there has also been an increase in the number of cases of this entity, although there is no correspondence with the arguments mentioned above concerning rich nations. The risk factors (RF) that are invoked when talking about its genesis must always be taken into account when dealing with its prevention. AIMS. To draw attention to the increase in the number of CVD in an under developed country, apparently due to the high frequency of the acquired immunodeficiency syndrome suffered by the population.

A study was conducted involving all the patients admitted to the Hospital Central de Beira between 1 January 1988 and 30 June 1999 with a clinical picture compatible with a CVD. They had all been examined by a neurologist (always the same one) and had also been submitted to serological tests to detect the human immunodeficiency virus (HIV).

Of the 155 cases with CVD, 56.7% were HIV+. Below the age of 50, CVD is generally not associated with any other RF.

These findings show that we must expect an increase in the morbidity and mortality from CVD in poor nations, which will balance out the difference that existed up to a few years ago with the more developed countries. The appearance of CVD in young subjects, without any other apparent cause, will force us to rule out a possible HIV infection in high risk individuals