Ischaemic cerebrovascular events in HIV infection: a cohort study

Cerebrovasc Dis. 2003;15(3):199-205. doi: 10.1159/000068828.

Abstract

Several case reports and series described ischaemic cerebrovascular events in HIV infection. However, the exact prevalence and the clinical features of these events are unknown. We performed a cohort study on 772 consecutive HIV infected patients and evaluated the rate of transient ischaemic attacks (TIA) and of completed stroke. A total prevalence of 1.9% for TIA (0.8%) and stroke (1.2%) was calculated resulting in an annual incidence rate of 216 per 100000. The prevalence was highest in the later stages of the infection. Stroke patients had a poorer immunological state than the TIA and the cohort patients. Probable (n = 3) and possible (n = 2) vasculitis and cardiogenic embolism (n = 2) could be detected as aetiology, the remaining patients had a cryptogenic event. Our data suggest that ischaemic cerebrovascular events are more common in HIV infected patients than in the general population and that a part of these events might be caused by HIV associated vasculitis or vasculopathy.

MeSH terms

  • Adult
  • Aged
  • Brain Edema / etiology
  • CD4 Antigens / metabolism
  • Cerebral Angiography
  • Cerebrovascular Disorders / epidemiology
  • Cerebrovascular Disorders / etiology*
  • Cerebrovascular Disorders / physiopathology
  • Cohort Studies
  • Electroencephalography
  • Evoked Potentials / physiology
  • Female
  • HIV Infections / complications*
  • Humans
  • Ischemic Attack, Transient / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Stroke / epidemiology
  • Stroke / etiology
  • Tomography, X-Ray Computed

Substances

  • CD4 Antigens