David R Bearden1, Bernard Omech2, Ikanyeng Rulaganyang3, Sheikh O Sesay4, Dennis L Kolson5, Scott E Kasner5, Michael T Mullen5. 1. Department of Neurology, University of Rochester, Rochester, NY, USA. Electronic address: David_bearden@urmc.rochester.edu. 2. Department of Medicine, Lira University, Lira, Uganda. 3. Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana. 4. Princess Marina Hospital Department of Radiology, Gaborone, Botswana. 5. Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
Abstract
OBJECTIVE: HIV is associated with an increased risk of stroke, but there are sparse data on risk factors for stroke in people living with HIV in Sub-Saharan African. The goal of this study was to identify HIV-specific stroke characteristics and risk factors among adults in Botswana. METHODS: We conducted a prospective cohort study in Gaborone, Botswana from June 2015 to June 2017 comparing risk factors and outcomes among adults with and without HIV admitted for acute stroke. In addition, we conducted a case-control study comparing patients with HIV and stroke to outpatients with HIV and no history of stroke. RESULTS: A total of 52 patients with imaging-confirmed acute stroke were enrolled. Stroke patients with HIV were younger than those without HIV (median age 40 vs 54, p = .005). Hypertension was the most common risk factor identified in both HIV+ and HIV- groups, but was more common in patients without HIV (81% vs. 55%, p = .04). Patients with HIV were significantly more likely to have a small-vessel lacunar syndrome compared to patients without HIV (67% vs. 29%, p = .02). In the case-control analysis, patients with HIV and stroke were more likely to have hypertension than stroke-free controls (53% vs. 16%; OR 7.2, 95% CI 1.5-33.8, p = .01), and were more likely to drink alcohol (53% vs. 21%, OR 3.7, 95% CI 1.1-12.1, p = .03). CONCLUSIONS: Individuals with HIV present with strokes at younger ages than individuals without HIV. Among those with HIV, hypertension and alcohol use are significant risk factors for stroke.
OBJECTIVE: HIV is associated with an increased risk of stroke, but there are sparse data on risk factors for stroke in people living with HIV in Sub-Saharan African. The goal of this study was to identify HIV-specific stroke characteristics and risk factors among adults in Botswana. METHODS: We conducted a prospective cohort study in Gaborone, Botswana from June 2015 to June 2017 comparing risk factors and outcomes among adults with and without HIV admitted for acute stroke. In addition, we conducted a case-control study comparing patients with HIV and stroke to outpatients with HIV and no history of stroke. RESULTS: A total of 52 patients with imaging-confirmed acute stroke were enrolled. Stroke patients with HIV were younger than those without HIV (median age 40 vs 54, p = .005). Hypertension was the most common risk factor identified in both HIV+ and HIV- groups, but was more common in patients without HIV (81% vs. 55%, p = .04). Patients with HIV were significantly more likely to have a small-vessel lacunar syndrome compared to patients without HIV (67% vs. 29%, p = .02). In the case-control analysis, patients with HIV and stroke were more likely to have hypertension than stroke-free controls (53% vs. 16%; OR 7.2, 95% CI 1.5-33.8, p = .01), and were more likely to drink alcohol (53% vs. 21%, OR 3.7, 95% CI 1.1-12.1, p = .03). CONCLUSIONS: Individuals with HIV present with strokes at younger ages than individuals without HIV. Among those with HIV, hypertension and alcohol use are significant risk factors for stroke.
Authors: Craig Corbett; Naeem Brey; Richard D Pitcher; Suzanne O'Hagan; Tonya M Esterhuizen; Felicia C Chow; Eric H Decloedt Journal: Neurology Date: 2022-06-03 Impact factor: 11.800
Authors: Amir A Mbonde; Jonathan Chang; Abdu Musubire; Samson Okello; Adrian Kayanja; Moses Acan; Jacob Nkwanga; Andrew Katende; Felicia C Chow; Deanna Saylor; Cumara O'Carroll; Mark J Siedner Journal: J Stroke Cerebrovasc Dis Date: 2022-04-25 Impact factor: 2.677