George Ransley1, Stanley Zimba2, Yohane Gadama3,4, Deanna Saylor2,5, Laura Benjamin6,7. 1. National Hospital for Neurology and Neurosurgery, University College London Foundation Trust, London, UK. 2. Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia. 3. Division of Neurology, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa. 4. Malawi-Liverpool Wellcome Trust Clinical Research Program, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi. 5. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 6. National Hospital for Neurology and Neurosurgery, University College London Foundation Trust, London, UK. l.benjamin@ucl.ac.uk. 7. MRC LMCB, University College London, Gower Street, London, WC1E 6BT, UK. l.benjamin@ucl.ac.uk.
Abstract
PURPOSE OF THE REVIEW: To describe trends and clinical characteristics of HIV and cerebrovascular disease between 1990 and 2021 in LMICs and identify the gaps in our understanding. RECENT FINDINGS: In the era of antiretroviral therapy (ART), people living with HIV (PLWH) live longer and risk excess cerebrovascular events due to ageing and HIV-driven factors. Despite the highest burden of HIV infection in low-to-middle income countries, there is underreporting in the literature of cerebrovascular events in this population. We systematically reviewed published literature for primary clinical studies in adult PLWH and cerebrovascular disease in LMICs. The clinical phenotype of cerebrovascular disease among PLWH over the last three decades in LMICs has evolved and transitioned to an older group with overlapping cerebrovascular risk factors. There is an important need to increase research in this population and standardise reporting to facilitate understanding, guide development of appropriate interventions, and evaluate their impact.
PURPOSE OF THE REVIEW: To describe trends and clinical characteristics of HIV and cerebrovascular disease between 1990 and 2021 in LMICs and identify the gaps in our understanding. RECENT FINDINGS: In the era of antiretroviral therapy (ART), people living with HIV (PLWH) live longer and risk excess cerebrovascular events due to ageing and HIV-driven factors. Despite the highest burden of HIV infection in low-to-middle income countries, there is underreporting in the literature of cerebrovascular events in this population. We systematically reviewed published literature for primary clinical studies in adult PLWH and cerebrovascular disease in LMICs. The clinical phenotype of cerebrovascular disease among PLWH over the last three decades in LMICs has evolved and transitioned to an older group with overlapping cerebrovascular risk factors. There is an important need to increase research in this population and standardise reporting to facilitate understanding, guide development of appropriate interventions, and evaluate their impact.
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