HIV Associated Risk Factors for Ischemic Stroke and Future Perspectives

Area of Science:

• Neuroscience
• Infectious Diseases
• Cardiovascular Medicine

Background:

• Antiretroviral therapy (ART) has transformed HIV infection into a manageable chronic condition.
• Despite effective treatment, HIV-infected individuals face a higher prevalence of comorbidities, notably cardiovascular and cerebrovascular diseases.
• The incidence of stroke is significantly elevated in HIV-infected individuals compared to uninfected controls.

Purpose of the Study:

• To comprehensively review the risk factors contributing to ischemic stroke in HIV-infected patients.
• To outline experimental evidence on how HIV infection impacts stroke outcomes.
• To discuss potential novel therapeutic strategies for improving stroke outcomes in this population.

Main Methods:

• Review of clinical and postmortem studies on stroke incidence in HIV-infected patients.
• Analysis of experimental studies in murine models of ischemic stroke.
• Examination of the role of HIV viral proteins and ART in stroke pathogenesis.

Main Results:

• HIV infection is associated with a threefold increase in stroke incidence.
• HIV infection exacerbates stroke outcomes, increases blood-brain barrier permeability, and promotes neuroinflammation.
• Factors such as coagulopathies, opportunistic infections, vascular abnormalities, atherosclerosis, diabetes, and ART contribute to stroke risk.

Conclusions:

• Understanding the multifactorial etiology of stroke in HIV is crucial.
• HIV-related factors, including viral proteins and ART, significantly impact stroke pathogenesis and outcomes.
• Further research into novel therapeutic approaches is warranted to mitigate stroke risk and improve outcomes in HIV-infected patients.