Short Communication: Ischemic Stroke Subtypes Among Thai HIV-Infected Patients: A 12-Year Retrospective Study.
AIDS Res Hum Retroviruses
; 37(9): 627-630, 2021 09.
Article
in En
| MEDLINE
| ID: mdl-34006124
ABSTRACT
Traditional vascular risk factors and HIV-related factors can contribute to higher prevalence of ischemic stroke (IS) among HIV-infected patients. Understanding the underlying mechanism of IS could lead to proper management and prognosis. We aimed to determine the prevalence of IS subtypes among HIV-infected patients who were hospitalized due to IS. Medical records of patients who were hospitalized at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between 2008 and 2019 due to first-ever IS with documented HIV infection were retrospectively analyzed. IS subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Among 6,952 patients who were hospitalized due to IS, 50 [0.7% (95% confidence interval 0.5-1.0)] were HIV-infected patients and were included in the analysis. Common traditional stroke risk factors were dyslipidemia (62%), smoking (55.3%), hypertension (52%), and alcohol consumption (45%). The median (interquartile range) CD4 cell count was 294.5 (186-485) cells/mL and 74% were on antiretroviral therapy. The most common etiology of IS was small vessel occlusion (SVO) (48%), followed by stroke of undetermined etiology (UD) (26%), and stroke of other determined etiology (OD) (14%). Among patients with OD, 5 of 7 were from infectious-related cause. Virologically unsuppressed group had significantly higher proportion of OD (33.3% vs. 3.6%), UD (38.9% vs. 17.9%), and lower proportion of SVO (22.2% vs. 60.7%) based on TOAST classification compared with virologically suppressed group (p = .01). SVO was the most common cause of IS among HIV-infected patients and was more likely to occur among virologically suppressed group, suggesting that traditional vascular risk factors may play a larger role in developing IS. OD was more likely to occur among virologically unsuppressed group, most of which were infectious-related cause.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
Brain Ischemia
/
Stroke
/
Ischemic Stroke
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
Asia
Language:
En
Journal:
AIDS Res Hum Retroviruses
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2021
Document type:
Article
Affiliation country:
Thailand