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Ischaemic cerebrovascular events in HIV infection: a cohort study
Stefan Evers1, Darius Nabavi, Alexandra Rahmann
1Department of Neurology, University of Münster, Germany. everss@uni-muenster.de
Insights
Ischaemic cerebrovascular events, including transient ischaemic attacks and stroke, are more common in HIV-infected patients. These events appear more frequent in later infection stages and may be linked to HIV-associated vasculitis.
Area of Science:
- Neurology
- Infectious Diseases
- Epidemiology
Background:
- Case reports suggest a link between Human Immunodeficiency Virus (HIV) infection and ischaemic cerebrovascular events.
- The precise prevalence and clinical characteristics of these events in HIV patients remain unclear.
Purpose of the Study:
- To determine the prevalence and incidence of transient ischaemic attacks (TIA) and stroke in HIV-infected individuals.
- To investigate the clinical features and potential causes of cerebrovascular events in this population.
Main Methods:
- A cohort study involving 772 consecutive HIV-infected patients was conducted.
- The study evaluated the rates of TIA and completed stroke within the cohort.
Main Results:
- A total prevalence of 1.9% for TIA (0.8%) and stroke (1.2%) was observed, with an annual incidence rate of 216 per 100,000.
- Prevalence was highest in later stages of HIV infection, and stroke patients exhibited poorer immunological status.
- Identified potential causes included vasculitis (n=5) and cardiogenic embolism (n=2); most events were cryptogenic.
Conclusions:
- Ischaemic cerebrovascular events are more common in HIV-infected patients than in the general population.
- A portion of these events may be attributable to HIV-associated vasculitis or vasculopathy.
Abstract:
Several case reports and series described ischaemic cerebrovascular events in HIV infection. However, the exact prevalence and the clinical features of these events are unknown. We performed a cohort study on 772 consecutive HIV infected patients and evaluated the rate of transient ischaemic attacks (TIA) and of completed stroke. A total prevalence of 1.9% for TIA (0.8%) and stroke (1.2%) was calculated resulting in an annual incidence rate of 216 per 100000. The prevalence was highest in the later stages of the infection. Stroke patients had a poorer immunological state than the TIA and the cohort patients. Probable (n = 3) and possible (n = 2) vasculitis and cardiogenic embolism (n = 2) could be detected as aetiology, the remaining patients had a cryptogenic event. Our data suggest that ischaemic cerebrovascular events are more common in HIV infected patients than in the general population and that a part of these events might be caused by HIV associated vasculitis or vasculopathy.