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HIV Associated Risk Factors for Ischemic Stroke and Future Perspectives

Saifudeen Ismael1, Mohammad Moshahid Khan2,3, Prashant Kumar4

  • 1Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN 38163, USA.

International Journal of Molecular Sciences
|July 30, 2020
PubMed

Insights

Antiretroviral therapy has made HIV chronic, but increases stroke risk in patients. HIV infection worsens stroke outcomes, highlighting the need for new therapeutic strategies.

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.

Keywords:
HIVextracellular vesiclesglycoprotein-120ischemic stroketrans-activator of transcription

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