HIV patients suffer more strokes

by Aimee Keenan-Greene

A new study in the journal Neurology says over the last decade there has been a significant rise in HIV patients hospitalized for stroke. 

Dr. Bruce Ovbiagele of the Stroke Center and Department of Neuroscience at the University of California at San Diego says large-scale epidemiologic data on stroke in HIV-infected persons is scarce, especially in an era of combination antiretroviral therapies, which have prolonged patient survival, but may boost stroke risk. 

Ovbiagele set out to assess trends in the proportion of HIV infection among patients with stroke in the United States by collecting data from all states within the United States that contributed to the Nationwide Inpatient Sample. 

All patients admitted to hospitals between 1997 and 2006 with a primary discharge diagnosis of stroke (identified by the International Classification of Diseases, Ninth Revision procedure codes) were included. 

Time trends in the proportion of these patients with HIV diagnosis were computed, and independent predictors of comorbid HIV diagnosis evaluated using multivariable logistic regression. 

Ovbiagele found of both ischemic and hemorrhagic stroke hospitalizations, patients with comorbid HIV infection constituted 0.09 percent in 1997 vs 0.15 percent in 2006. 

Actual numbers of overall US stroke hospitalizations lessened 7 percent, while actual numbers of stroke hospitalizations with coexisting HIV infection rose 60 percent (888 to 1,425). 

Patients with comorbid HIV infection comprised 0.08 percent of ischemic strokes in 1997 vs 0.18 percent in 2006, but their proportion of hemorrhagic strokes did not significantly change. 

Factors independently associated with higher odds of comorbid HIV diagnosis were Medicaid insurance, urban hospital type, dementia, liver disease, renal disease, and cancer. 

The Centers for Disease Control and Prevention say human immunodeficiency virus can lead to acquired immune deficiency syndrome, or AIDS.

CDC estimates that about 56,000 people in the United States contracted HIV in 2006.

There are two types of HIV, HIV-1 and HIV-2. In the United States, unless otherwise noted, the term “HIV” primarily refers to HIV-1. 

Both types of HIV damage a person’s body by destroying specific blood cells, called CD4+ T cells, which are crucial to helping the body fight diseases.

Within a few weeks of being infected with HIV, some people develop flu-like symptoms that last for a week or two, but others have no symptoms at all. 

People living with HIV may appear and feel healthy for several years. 

Untreated early HIV infection is also associated with many diseases including cardiovascular disease, kidney disease, liver disease, and cancer.  Support services are also available to many people with HIV. These services can help people cope with their diagnosis, reduce risk behavior, and find needed services.

Despite major advances in diagnosing and treating HIV infection, in 2007 there were 35,962 cases of AIDS diagnosed and 14,110 deaths among people living with HIV were reported in the United States.