Abstract

BackgroundStroke in human immunodeficiency virus positive (HIV+) individuals is becoming an increasing concern. Being significantly younger than typical stroke patients, the impact of functional challenges on quality of life and burden on society becomes more eminent.ObjectivesThis feasibility study aims to determine the requirements for a large descriptive cohort, to adequately describe the functional outcome of stroke patients with varying HIV status.Method All stroke patients meeting the inclusion criteria were recruited over a 6-month period at a South African inpatient rehabilitation centre. Data were collected on admission and discharge using outcome measures including the Barthel Index (BI), Berg Balance Scale (BBS) and the use of assistive devices used to describe independence with activities of daily living (ADL), mobility and safety post-stroke. Statistical analysis was performed using Stata version 14.2.ResultsThe feasibility study identified appropriate procedures and barriers to a successful study in addition to describing preliminary data on participant demographics, relevant medical history and functional outcomes post-stroke. Limitations that affected feasibility included minimal recruitment sites, length of data collection period, timely communication of participant discharge plans and dates, and confirmation of participant HIV status. An appropriate comparison between sub-groups could not be made because of disproportionate group sizes, median age differences and no assessor blinding.ConclusionTo increase generalisability and the understanding of the unique HIV+ stroke profile, multiple recruitment sites, longer data collection periods, assessor blinding and age-matched groups with HIV status confirmation are recommended.

Highlights

  • Functional outcomes may differ between stroke patients who are human immunodeficiency virus-negative (HIV-) and those who are HIV-positive (HIV+) because of differences in demographic characteristics, risk factors and disease manifestations (Heikinheimo et al 2012; Tipping et al 2007; Verma et al 2012)

  • Information on the functional outcomes of HIV+ people with stroke who reside in sub-Saharan Africa and how much they differ from their typical stroke counterparts is still sparse

  • The Beta assessment tool has not yet been validated in a South African stroke cohort, and this study found no significant difference between HIV+ and HIV- stroke patients

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Summary

Introduction

Functional outcomes may differ between stroke patients who are human immunodeficiency virus-negative (HIV-) and those who are HIV-positive (HIV+) because of differences in demographic characteristics, risk factors and disease manifestations (Heikinheimo et al 2012; Tipping et al 2007; Verma et al 2012). It is concerning that those with HIV-related strokes are found to be significantly younger than the typical stroke population (Heikinheimo et al 2012; Mlay & Bakari 2012). This may pose a greater burden in subSaharan Africa as 34% of HIV+ people are aged between 15 and 24 years, whereas globally only 22% of the HIV population are in this age range (UNAIDS 2016). Being significantly younger than typical stroke patients, the impact of functional challenges on quality of life and burden on society becomes more eminent

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