Abstract
BackgroundWe aimed to clarify the characteristics, risk factors, and prognosis of stroke among HAART-naive people living with HIV (PLWH) in China.MethodsWe selected HAART-naive PLWH admitted to Beijing Ditan Hospital, Capital Medical University, from 1 January 2009 to 31 December 2019. Demographic and clinical data were obtained by searching an anonymous electronic case system. Descriptive analysis and logistic regression and Cox proportional hazard models were used to determine the characteristics and predictors of stroke among all HAART-naive PLWH and evaluate the risk factors of mortality in HAART-naive PLWH with stroke.ResultsStroke was diagnosed in 105 cases (3.7%) of 2867 HAART-naive PLWH. Multivariate logistic regression indicated that age of 30–55 years (OR 1.903, 95% CI 1.005–3.603, p = 0.048), age of ≥ 55 years (OR 4.104, 95% CI 1.928–8.737, p < 0.001), and CD4 count of < 200 cells/µL (OR 2.005, 95% CI 1.008–3.985, p = 0.047) were associated with increased odds of stroke. Diabetes (OR 3.268, 95% CI 1.744–6.125, p < 0.001), hypertension (OR 2.301, 95% CI 1.425–3.717, p = 0.001), syphilis (OR 2.003, 95% CI 1.300–3.089, p = 0.002), and complicated AIDS-defining CNS diseases (OR 7.719, 95% CI 4.348–13.703, p < 0.001) were risk factors for stroke. Of the 105 stroke patients, 12 (11.4%) died during hospitalisation, and the risk factors for mortality among patients with stroke were age of > 65 years (AHR: 8.783, 95% CI 1.522–50.668, p = 0.015), complicated severe pneumonia (AHR: 3.940, 95% CI 1.106–14.029, p = 0.034), and AIDS-defining CNS diseases (AHR: 19.766, 95% CI 3.586–108.961, p = 0.001).ConclusionsFor HAART-naive people living with HIV (PLWH), stroke occurred in various age groups, and early screening for stroke, timely intervention for risk factors among patients in various age groups, and controlling the CD4 count are extremely important in reducing the burden of stroke.
Highlights
The development of highly active antiretroviral therapy (HAART) has transformed fatal HIV infection into a chronic and controllable disease, and the life expectancyZhang et al BMC Infectious Diseases (2022) 22:4 of people living with HIV (PLWH) receiving antiretroviral regimens (ARV) has greatly increased [1]
Diabetes, hypertension, syphilis, and complicated Acquired immunodeficiency syndrome (AIDS)-defining central nervous system (CNS) diseases were risk factors for stroke
Of the 105 stroke patients, 12 (11.4%) died during hospitalisation, and the risk factors for mortality among patients with stroke were age of > 65 years (AHR: 8.783, 95% CI 1.522–50.668, p = 0.015), complicated severe pneumonia (AHR: 3.940, 95% CI 1.106–14.029, p = 0.034), and AIDS-defining CNS diseases (AHR: 19.766, 95% CI 3.586–108.961, p = 0.001)
Summary
The development of highly active antiretroviral therapy (HAART) has transformed fatal HIV infection into a chronic and controllable disease, and the life expectancyZhang et al BMC Infectious Diseases (2022) 22:4 of people living with HIV (PLWH) receiving antiretroviral regimens (ARV) has greatly increased [1]. The development of highly active antiretroviral therapy (HAART) has transformed fatal HIV infection into a chronic and controllable disease, and the life expectancy. HIV infection was confirmed based on routine screening on admission due to comorbidities, which indicated that different comorbidities, including AIDS-defining and non-AIDS-defining events, should be considered in HAART-naive PLWH. The predictors of stroke and the subsequent risk factors of mortality among HAART-naive PLWH have not been elucidated. This study aimed to report the characteristics and predictors of stroke among all HAART-naive PLWH and evaluate the risk factors of mortality in HAARTnaive PLWH with stroke, which will help clinicians perform early screening and timely interventions to reduce the occurrence of stroke and improve prognosis. We aimed to clarify the characteristics, risk factors, and prognosis of stroke among HAART-naive people living with HIV (PLWH) in China
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