Relationship between Younger Age, Autoimmunity, Cardiometabolic Risk, Oxidative Stress, HAART, and Ischemic Stroke in Africans with HIV/AIDS.

Benjamin Longo-Mbenza,Etienne Mokondjimobe,Murielle Longokolo Mashi,Bertrand Ellenga-Mbolla,Nelly Kangola Kabangu,Simon Mbungu Fuele,Augustin Nge Okwe,Thierry Gombet,Michel Lelo Tshikwela

doi:10.5402/2011/897908

Benjamin Longo-Mbenza, Etienne Mokondjimobe + Show 7 more

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https://doi.org/10.5402/2011/897908

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Abstract

Background and Purpose. It now appears clear that both HIV/AIDS and antiretroviral therapy (HAART) use are associated with higher risk of cardiovascular disease such as stroke. In this study, we evaluated the prevalence, the risk factors, and the cardiometabolic comorbidities of stroke in HIV/AIDS Central African patients. Methods. This hospital-based cross-sectional study collected clinical, laboratory, and imaging data of black Central African heterosexual, intravenous drug nonuser, and HIV/AIDS patients. Results. There were 54 men and 62 women, with a female to male ratio of 1.2 : 1. All were defined by hypercoagulability and oxidative stress. Hemorrhagic stroke was reported in 1 patient, ischemic stroke in 17 patients, and all stroke subtypes in 18 patients (15%). Younger age <45 years (P = .003), autoimmunity (P < .0001), and metabolic syndrome defined by IDF criteria (P < .0001) were associated with ischemic stroke. Conclusions. Clustering of several cardiometabolic factors, autoimmunity, oxidative stress, and lifestyle changes may explain accelerated atherosclerosis and high risk of stroke in these young black Africans with HIV/AIDS. Prevention and intervention programs are needed.

Highlights

Background and PurposeIt appears clear that both HIV/AIDS and antiretroviral therapy (HAART) use are associated with higher risk of cardiovascular disease such as stroke
It appears clear that both HIV infection itself and HAART use are associated with higher risk of stroke and metabolic disorders [3,4,5]
Blood pressure (BP) including systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (SBP-DBP) after the participant had rested for 10 minutes seated in a quiet room, was measured in the left arm with elbow flexed at heart level using an Omron HEM 705 electronic BP manometer

Summary

Introduction

Background and PurposeIt appears clear that both HIV/AIDS and antiretroviral therapy (HAART) use are associated with higher risk of cardiovascular disease such as stroke. The majority of Central African HIV-infected patients do not have access to drugs of the first line and are not systematically on HAART till It is not established whether the HIV infection itself [4], the progression from asymptomatic to symptomatic HIV disease, aging, lifestyle changes, reduction of defining HIV disease infections and tumors, ARV exposure, and traditional and new cardiovascular risk factors directly cause stroke in Central African HIVinfected patients. In these Africans, severe hypertension, hyperuricemia, hyperglycemia, high levels of Dr dimer and fibrinogen, smoking, excessive alcohol intake, Helicobacter

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