Stroke rate rises for patients with HIV infection

January 19, 2011

While the overall hospitalization rate for stroke has declined in recent years, the numbers have jumped dramatically for patients infected with human immunodeficiency virus (HIV), suggesting they may be up to three times more likely to suffer a stroke than people uninfected by the virus that causes AIDS.

In a paper published in the Jan. 19 online issue of Neurology, Bruce Ovbiagele, MD, professor of neurosciences at the University of California, San Diego School of Medicine and Avindra Nath, MD, of Johns Hopkins University, reviewed a national dataset of all hospital patients primarily diagnosed with stroke between the years 1997 and 2006.

They found that the number of stroke diagnoses in the general population declined 7 percent during this time period (to 926,997 from 998,739) while stroke diagnoses among HIV-infected patients rose 67 percent (to 1,425 from 888). The rise in strokes among HIV patients was entirely driven by an increase in ischemic strokes, which are caused by impaired blood flow to the brain due to clots. Ischemic strokes are significantly more common than hemorrhagic strokes, which involve leakage of blood from the circulatory system into the brain.

Strokes can result in rapidly occurring, permanent loss of brain function due to severely reduced or interrupted blood supply to the brain. They are the third leading cause of death in the United States, with more than 143,579 fatalities annually, and the leading cause of serious, long-term disability.

"Generally speaking, strokes in patients with HIV are not common, so the rise is notable," said Ovbiagele, who is also a staff physician in the VA San Diego Healthcare System. He noted that the time period studied coincides with the emergence and widespread use of highly active antiretroviral therapy (HAART) for HIV patients. HAART has been notably successful in extending the lives of HIV/AIDS patients, but Ovbiagele said emerging data suggest that these drugs can be associated with metabolic complications linked to higher risk of stroke.

"The rise in HIV stroke rate may simply be because patients are living longer," Ovbiagele said. "Stroke risk is highly correlated with increasing age. Almost three-quarters of strokes occur after the age of 65. Indeed, after 55, the risk doubles for each successive decade."

However, among HIV patients the average age for a stroke was in the 50s and Ovbiagele said it has been previously shown that drugs used in HAART affect lipid and glucose levels, which are metabolic biomarkers associated with ischemic stroke risk.

Ovbiagele intends to pursue further studies to better examine the relationship between HIV drug treatment, metabolic complications and stroke risk.

"Patients on HAART will clearly need to remain on the drugs to extend their lives, but the challenge will be to clarify whether HAART therapy is an innocent bystander or a direct culprit in this process. Furthermore, it would be helpful to find out if rates of myocardial infarctions, more commonly known as heart attacks, are rising among HIV patients since they share similar underlying biological mechanisms to ischemic strokes."

Related Stories

Recommended for you

'Selfish brain' wins out when competing with muscle power, study finds

October 20, 2017
Human brains are expensive - metabolically speaking. It takes lot of energy to run our sophisticated grey matter, and that comes at an evolutionary cost.

Researchers find shifting relationship between flexibility, modularity in the brain

October 19, 2017
A new study by Rice University researchers takes a step toward what they see as key to the advance of neuroscience: a better understanding of the relationship between the brain's flexibility and its modularity.

Want to control your dreams? Here's how

October 19, 2017
New research at the University of Adelaide has found that a specific combination of techniques will increase people's chances of having lucid dreams, in which the dreamer is aware they're dreaming while it's still happening ...

Brain training can improve our understanding of speech in noisy places

October 19, 2017
For many people with hearing challenges, trying to follow a conversation in a crowded restaurant or other noisy venue is a major struggle, even with hearing aids. Now researchers reporting in Current Biology on October 19th ...

Investigating the most common genetic contributor to Parkinson's disease

October 19, 2017
LRRK2 gene mutations are the most common genetic cause of Parkinson's disease (PD), but the normal physiological role of this gene in the brain remains unclear. In a paper published in Neuron, Brigham and Women's Hospital ...

New procedure enables cultivation of human brain sections in the petri dish

October 19, 2017
Researchers at the University of Tübingen have become the first to keep human brain tissue alive outside the body for several weeks. The researchers, headed by Dr. Niklas Schwarz, Dr. Henner Koch and Dr. Thomas Wuttke at ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.