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Quantification of Cerebral Vascular Architecture using Two-photon Microscopy in a Mouse Model of HIV-induced Neuroinflammation
Published on: January 12, 2016
HIV infection and stroke: current perspectives and future directions
Laura A Benjamin1, Alan Bryer, Hedley C A Emsley
1Brain Infections Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.
The Lancet. Neurology
|September 22, 2012
Summary
HIV infection increases stroke risk through various mechanisms, including inflammation and certain treatments. Managing stroke in HIV patients requires addressing specific causes and optimizing combination antiretroviral therapies (cART).
Area of Science:
- Neurology
- Infectious Diseases
- Cardiology
Background:
- HIV infection is linked to stroke through opportunistic infections, vasculopathy, cardioembolism, and coagulopathy.
- HIV-associated vasculopathy encompasses cerebrovascular changes like stenosis, aneurysm, vasculitis, and atherosclerosis, with controversial causal mechanisms.
- Chronic inflammation from HIV and infections, alongside atherogenic combination antiretroviral therapies (cART), contributes to increased stroke risk.
Purpose of the Study:
- To review the mechanisms by which HIV infection can lead to stroke.
- To discuss the role of HIV-associated vasculopathy and combination antiretroviral therapies (cART) in stroke risk.
- To highlight the need for tailored stroke management and further research in HIV-infected individuals.
Main Methods:
- Review of epidemiological, clinical, biological, and autopsy studies.
- Analysis of the pathogenesis of HIV-associated vasculopathy and arterial endothelial damage.
- Evaluation of the long-term effects of cART on stroke risk.
Main Results:
- HIV infection presents multiple pathways to stroke, including direct and indirect effects on cerebrovasculature.
- cART, while beneficial for HIV management, can be atherogenic and potentially increase stroke risk.
- The aging HIV-positive population on cART faces a growing burden of stroke.
Conclusions:
- Stroke management in HIV patients necessitates identifying stroke causes, managing risk factors, and adjusting cART regimens.
- Further research is crucial to understand HIV-associated vasculopathy, long-term cART effects, and optimal stroke treatments.
- Development of antiretroviral therapies with reduced vascular risk is needed.
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