Stroke in Patients with HIV Infection: Is It Different? (P01.246)

Abstract

Objective: To describe epidemiological and clinical characteristics of stroke in HIV patients. Background Incidence of stroke in HIV population in United States is increasing over the last 2 decades. Antiretroviral therapy, metabolic syndrome, vasculopathy, and coagulopathy are thought to be factors causing premature strokes in HIV infected individuals. Design/Methods: Retrospective chart review of patients with a primary diagnosis of stroke and concurrent diagnosis of HIV or AIDS admitted to a comprehensive stroke center between 2005 and 2011 was performed. Results: Out of 1679 admissions with acute stroke we identified 43 patients (32 males and 11 females) with concurrent diagnosis of HIV. Mean age was 53 years old. All 43 patients had ischemic strokes confirmed by imaging. Eighteen patients (42%) were on HAART prior to stroke onset. Large vessel atherosclerosis was found in 20 patients (46.5%), small vessel occlusion in 18 (41.8%), cardioembolism in 3 (6.9%), 2 were cryptogenic (4.7%). Ten patients (23%) had recurrent strokes in the same or different vascular territories. CD4 count was available in 37 patients; 19 had CD4 >200 and 18 had CD4 Conclusions: Risk factors and morphological characteristics of stroke in patients with HIV tend to be similar to those in general population, yet they develop stroke at younger age. Immune status might not be a determining factor. Small sample size and retrospective nature of the study are major limiting factors in our analysis. Further prospective study would be aimed to identify specific biomarkers for stroke risk in HIV patients. Disclosure: Dr. Shah has nothing to disclose. Dr. Walker has nothing to disclose. Dr. Nigo has nothing to disclose. Dr. Skliut has nothing to disclose.