PURPOSE/AIM: Cerebrovascular events (CVE) in HIV infected patients have become an increasingly relevant neurological complication. Data about the prevalence and clinical features of CVE in HIV infected patients since the introduction of combined Anti-Retroviral Therapy (cART) are rare. METHODS: A retrospective study of HIV-infected patients with a CVE was performed from 2002 to 2011. During this time period 3203 HIV-infected patients were admitted to the University hospital of Münster, Germany. All patients had access to regular and long term treatment with cART. The clinical features were analyzed and the prevalence of ischemic stroke (IS), transient ischemic attack (TIA) and intracerebral bleeding (ICB) was calculated. RESULTS: The total prevalence of all CVE was at 0.6% (95% CI: 0.3, 0.8) (0.4% for IS (95% CI: 0.2, 0.6), 0.2% for TIA (95% CI: 0.0, 0.3) and 0.1% for ICB (95% CI: 0.0, 0.2)) and the crude annual incidence rate at 59 per 100.000 for all events. The median CD4 cell count was 405/μl (25th to 75th percentile: 251-568). The majority of patients had AIDS. The median age was at 49 years (25th to 75th percentile: 40-69). Some events were associated with HIV-associated vasculopathy or viral co-infections. Most patients presented with multiple vascular risk factors. CONCLUSION: The study confirms that CVE occur in HIV-infected patients with a good immune status and at a young age. HIV infection has to be considered in young stroke patients. The rate of CVE in this study was constant when comparing to the pre-cART era. HIV associated vasculopathy and viral co-infections need to be considered in the diagnostics of stroke.
PURPOSE/AIM: Cerebrovascular events (CVE) in HIV infectedpatients have become an increasingly relevant neurological complication. Data about the prevalence and clinical features of CVE in HIV infectedpatients since the introduction of combined Anti-Retroviral Therapy (cART) are rare. METHODS: A retrospective study of HIV-infectedpatients with a CVE was performed from 2002 to 2011. During this time period 3203 HIV-infectedpatients were admitted to the University hospital of Münster, Germany. All patients had access to regular and long term treatment with cART. The clinical features were analyzed and the prevalence of ischemic stroke (IS), transient ischemic attack (TIA) and intracerebral bleeding (ICB) was calculated. RESULTS: The total prevalence of all CVE was at 0.6% (95% CI: 0.3, 0.8) (0.4% for IS (95% CI: 0.2, 0.6), 0.2% for TIA (95% CI: 0.0, 0.3) and 0.1% for ICB (95% CI: 0.0, 0.2)) and the crude annual incidence rate at 59 per 100.000 for all events. The median CD4 cell count was 405/μl (25th to 75th percentile: 251-568). The majority of patients had AIDS. The median age was at 49 years (25th to 75th percentile: 40-69). Some events were associated with HIV-associated vasculopathy or viral co-infections. Most patients presented with multiple vascular risk factors. CONCLUSION: The study confirms that CVE occur in HIV-infectedpatients with a good immune status and at a young age. HIV infection has to be considered in young strokepatients. The rate of CVE in this study was constant when comparing to the pre-cART era. HIV associated vasculopathy and viral co-infections need to be considered in the diagnostics of stroke.
Entities:
Keywords:
AIDS; HIV; HIV vasculopathy; TIA; cART; cerebrovascular disease; stroke
Authors: Juan Ambrosioni; Francisca Artigues; David Nicolás; Judit Peñafiel; Fernando Agüero; Christian Manzardo; María Mar Mosquera; Sonsoles Sánchez-Palomino; Elisa De Lazzari; María A Marcos; Montserrat Plana; José M Miró Journal: J Neurovirol Date: 2017-07-17 Impact factor: 3.739
Authors: Marilza Campos de Magalhães; Juan Camilo Sánchez-Arcila; Ana Carolina de Brito Lyra; Luiz Felipe Boufleur Long; Isabelle Vasconcellos de Souza; Fernando Raphael de Almeida Ferry; Adilson José de Almeida; Soniza Vieira Alves-Leon Journal: PLoS One Date: 2020-02-12 Impact factor: 3.240