Abstract TP187: Risk of Subarachnoid Hemorrhage among Patients Infected with Human Immunodeficiency Virus

Abstract

Background: In the current literature, subarachnoid hemorrhage data among patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is limited to case reports. Objective: To compare the incidence and relative risk of subarachnoid hemorrhage (SAH) in patients with AIDS to those who are HIV negative, on a national level. Method: The Nationwide Inpatient Sample (NIS 2002-2010) was used to identify and all patients presenting with the primary diagnosis of SAH in the United States between 2002 and 2009. Among this cohort, we identified the patients with HIV/AIDS and those who were HIV negative and further stratified them based on gender and age: 13-24 years, 25-34 years, 35-44 years, 45-54 years and 55+ years. We obtained the number of people living with AIDS in the United States population from the Centers for Disease Control and Prevention (CDC) for 2002 according to the same age groups. Using the 2000 United States census information we identified the number of people in the general population and subtracted the AIDS cases within the respective age group. The relative risk of developing a SAH in patients with AIDS versus the HIV negative patients was also obtained between 2002 and 2009. Result: The age adjusted annual incidence of SAH was 62.3 per 100,000 and 20.2 per 100,000 among HIV/AIDS positive persons and HIV negative persons. The age adjusted annual relative risk for SAH among the HIV/AIDS positive persons was 3 (95% confidence interval 2.4 to 3.8). HIV positive women had higher incidence of SAH when compared to HIV positive males except for the 13-24 year old group. The SAH rate ratio decreased with each increasing decade when compared with HIV negative patients: 13-24 years (25), 25-34 years (8.6), 35-44 years (3), 45-54 years (2.4) and 55+ years (1.6). The 7 year incidence rate of SAH in HIV positive men between 13-24 years was 29 times more than in HIV negative men; similarly, the incidence of SAH among HIV positive women was 18 times that of HIV negative women. Conclusion: HIV/AIDS positive persons, particular young individuals, appear to have an increased risk of developing SAH.