Medical News

People With HIV Have High Stroke Risk: Study

January 25, 2011

U.S. stroke rates declined by 7 percent from 1997 to 2006, yet during the same period stroke rates in HIV patients increased 60 percent, a new study finds.

"Generally speaking, strokes in patients with HIV are not common, so the rise is notable," explained Dr. Bruce Ovbiagele of the University of California-San Diego and the VA San Diego Healthcare System. The team analyzed hospital discharge information on a nationally representative sample of patients with a primary diagnosis of stroke between 1997 and 2006.

The increase in ischemic strokes, which are caused by brain blood clots, was noteworthy. "Patients with comorbid HIV infection comprised 0.08 percent of ischemic strokes in 1997 vs. 0.18 percent in 2006 (p<0.0001), but their proportion of hemorrhagic strokes did not significantly change," the authors wrote.

Stroke occurs more frequently with advancing age, so the increase could reflect that fact that HIV patients on antiretroviral (ARV) treatment are living longer. However, HIV-positive stroke patients in the study tended to be in their 50s, younger than the average age of 65 for stroke patients.

Ovbiagele's team concluded that strong HIV drug cocktails could be playing a role. Previous studies have shown that HIV medicines affect blood fats and blood sugar levels -- two factors that are closely linked with strokes, said Ovbiagele.

Since HIV patients need to take ARVs for the rest of their lives, doctors should consider the potential stroke risk among these patients, Ovbiagele said.

The study, "Increasing Incidence of Ischemic Stroke in Patients With HIV Infection," was published online ahead of print in the journal Neurology (2011; doi:10.1212/WNL.0b013e31820a0cfc).

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