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Table of Contents
Vol. 27, No. 6, 2009
Issue release date: May 2009
Section title: Original Paper
Cerebrovasc Dis 2009;27:559–563
(DOI:10.1159/000214219)

Cerebrovascular Ischemic Events in HIV-1-Infected Patients Receiving Highly Active Antiretroviral Therapy: Incidence and Risk Factors

Corral I. · Quereda C. · Moreno A. · Pérez-Elías M.-J. · Dronda F. · Casado J.-L. · Muriel A. · Masjuán J. · Alonso-de-Leciñana M. · Moreno S.
aStroke Unit, Neurology Service, bInfectious Diseases Service, and cBiostatistics Unit, Hospital Ramón y Cajal, Madrid, Spain

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 9/12/2008
Accepted: 1/4/2009
Published online: 4/24/2009

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 1

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED

Abstract

Background: Stroke risk is increased in AIDS patients, and highly active antiretroviral therapy (HAART) may accelerate atherosclerosis, but little is known about the incidence and risk factors for ischemic stroke in patients under HAART. We have studied the incidence, types of stroke and possible risk factors for cerebrovascular ischemic events in a large cohort of HIV-1-infected patients treated with HAART. Methods: We conducted a retrospective review of ischemic strokes and transient ischemic attacks occurring in a cohort of HIV-1-infected patients treated with HAART from 1996 to 2008. As a control group, consecutive unselected patients from the same cohort were included. Patients and controls were compared for demographic, clinical and laboratory variables, including vascular risk factors, data on HIV infection and duration of HAART. Variables with significant differences were included in a backward logistic regression model. Results: Twenty-seven cerebrovascular ischemic events occurred in 25 patients, with an incidence of 189 events (166 strokes) per 100,000 patients/year. Independent factors associated with cerebrovascular events were: history of high alcohol intake (OR 7.13, 95% CI 1.69–30.11; p = 0.007), a previous diagnosis of AIDS (OR 6.61, 95% CI 2.03–21.51; p = 0.002) and fewer months under HAART (OR 0.97, 95% CI 0.96–0.99; p < 0.001). Six patients (24%) had large artery atherosclerosis: they had a similar HAART duration to controls. Conclusions: Stroke incidence is high in patients with HIV-1 infection treated with HAART. Duration of HAART exerted a global protective effect for cerebrovascular ischemic events, and our results do not support a major role in large artery atherosclerosis stroke. High alcohol intake is a major risk factor for stroke in these patients.


  

Author Contacts

Dr. Iñigo Corral
Servicio de Neurología, Hospital Ramón y Cajal
Carretera de Colmenar km 9.1
ES–28034 Madrid (Spain)
Tel. +34 915 944 813, Fax +34 913 580 614, E-Mail icorral.hrc@salud.madrid.org

  

Article Information

Received: September 12, 2008
Accepted: January 4, 2009
Published online: April 24, 2009
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 1, Number of References : 13

  

Publication Details

Cerebrovascular Diseases

Vol. 27, No. 6, Year 2009 (Cover Date: May 2009)

Journal Editor: Hennerici M.G. (Mannheim)
ISSN: 1015-9770 (Print), eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 9/12/2008
Accepted: 1/4/2009
Published online: 4/24/2009

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 1

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED


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