Ischaemic stroke in HIV-infected patients: a case-control study

Area of Science:

• Neurology
• Infectious Diseases
• Cardiology

Background:

• HIV infection is associated with increased cerebrovascular disease risk.
• Antiretroviral therapy (ART) has transformed HIV management but long-term effects on vascular health require ongoing study.
• Understanding stroke risk factors in HIV-infected individuals is critical for comprehensive patient care.

Purpose of the Study:

• To investigate the roles of HIV infection stage, ART, and vascular risk factors in ischaemic stroke among HIV-infected patients.
• To identify specific factors contributing to cerebrovascular events in this population.

Main Methods:

• A case-control study comparing HIV-infected patients with ischaemic stroke or transient ischaemic attack (TIA) to matched controls without stroke.
• Data collected from patients followed at a single clinic between January 2006 and June 2014.

Main Results:

• Ischaemic stroke was significantly associated with diabetes, smoking, low high-density lipoprotein (HDL) cholesterol, illegal drug use, low CD4 count, and high viral load.
• Small-vessel occlusion was the most common stroke aetiology, followed by large-artery atherosclerosis and cardioembolism.
• No significant differences were observed in HIV stage, nadir CD4 count, HIV duration, ART use, or treatment compliance between cases and controls.

Conclusions:

• Illegal drug use, uncontrolled HIV replication, and traditional vascular risk factors are associated with ischaemic cerebral events in HIV-infected patients.
• Cerebrovascular disease is an important comorbidity in aging HIV patients and requires proactive management.
• Comprehensive care for HIV-infected individuals must include managing vascular risk factors in addition to controlling HIV infection with ART.