HIV Status and the Risk of Ischemic Stroke Among Men

Overview

Journal Neurology

Specialty Neurology

Date 2015 Apr 12

PMID 25862803

Citations 101

Authors

Jason J Sico

Chung-Chou H Chang

Kaku So-Armah

Amy C Justice

Elaine Hylek

Melissa Skanderson

Kathleen McGinnis

Lewis H Kuller

Kevin L Kraemer

David Rimland

Matthew Bidwell Goetz

Adeel A Butt

Maria C Rodriguez-Barradas

Cynthia Gibert

David Leaf

Sheldon T Brown

Jeffrey Samet

Lewis Kazis

Kendall Bryant

Matthew S Freiberg

Affiliations

Soon will be listed here.

Abstract

Objective: Given conflicting data regarding the association of HIV infection and ischemic stroke risk, we sought to determine whether HIV infection conferred an increased ischemic stroke risk among male veterans.

Methods: The Veterans Aging Cohort Study-Virtual Cohort consists of HIV-infected and uninfected veterans in care matched (1:2) for age, sex, race/ethnicity, and clinical site. We analyzed data on 76,835 male participants in the Veterans Aging Cohort Study-Virtual Cohort who were free of baseline cardiovascular disease. We assessed demographics, ischemic stroke risk factors, comorbid diseases, substance use, HIV biomarkers, and incidence of ischemic stroke from October 1, 2003, to December 31, 2009.

Results: During a median follow-up period of 5.9 (interquartile range 3.5-6.6) years, there were 910 stroke events (37.4% HIV-infected). Ischemic stroke rates per 1,000 person-years were higher for HIV-infected (2.79, 95% confidence interval 2.51-3.10) than for uninfected veterans (2.24 [2.06-2.43]) (incidence rate ratio 1.25 [1.09-1.43]; p < 0.01). After adjusting for demographics, ischemic stroke risk factors, comorbid diseases, and substance use, the risk of ischemic stroke was higher among male veterans with HIV infection compared with uninfected veterans (hazard ratio 1.17 [1.01-1.36]; p = 0.04).

Conclusions: HIV infection is associated with an increased ischemic stroke risk among HIV-infected compared with demographically and behaviorally similar uninfected male veterans.

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