AVC

HIV infection is an independent risk factor for stroke

AVC

A HIV infection is linked to a much greater risk of stroke, according to research conducted in North America, published in an electronic edition of Journal of Acquired Immune Deficiency Syndromes.

The association between infection by the AIDS virus and stroke remained at a significant level after some studies and options for controlling the disease. Of the factors that are related to HIV infection, viral load has proved to be the most important factor of all.

The possibility of stroke increased parallel to viral load growth, suggesting that inadequate viral control and the inherent inflammatory and immunological sequelae may exacerbate the risk of vascular / cerebral risk.

Today it is common knowledge that the human immunodeficiency virus associated with this accent risk of cardiovascular disease. Despite this, the thrombogenic effect of HIV is still not clear and everything is in the field of theories; however, the risk exists.

It was with the best measure of this link that Boston scientists outlined a study, which compared the incidence rate of stroke in 4 308 seropositive people between 2005 and 2007 and 32 000 seronegative people as a control group for the analysis.

There was a wide prevalence of stroke risk factors in people with HIV, such as high blood pressure, diabetes, unhealthy smoking habits, cardiomyopathies, left heart valve disease and coronary insufficiency.

132 AVC has been noted in people with HIV and 782 in people who do not carry the virus. The Index was 5.27 per thousand patients / year among HIV positive and 3.75 people every thousand patients / year in people who are not HIV positive.

Within this analysis of the investigators, HIV infection has been linked to a gain of approximately 40% in the risk of Stroke (HR = 1.40; 95% IC, 1.17-1.69, p <0.001).

And even considering that traditional risk factors have mitigated this value, the risk of stroke remained remarkably high in people with Human Immunodeficiency Virus (HIV) (HR = 1.21; 95% IC, 1.01-1.46, p = 0.046 ).

"Smoking and Hypertension were risk factors with a higher prevalence among people with HIV and significantly associated with stroke," the authors of the study emphasize. "These factors can therefore be targets of important interventions with the community seropositive

This linkage between HIV infection and the increased risk of stroke was much more significant among women (HR = 2.16; 95% IC, 1.53-3.04, p <0.001) than in men (HR = 1.18; 95% IC, 0.95-1.47, p = 0.14).

In addition, the compounded risk of stroke in people who are seropositive for virus was more restricted to younger people (18 to 49 years). As an example, seropositive individuals aged 18 and 29 years had a four-fold higher risk than those who did not carry the virus in the same age group used for control (RNA = 4.42; 95% IC, 1.56-11.09).

The role of HIV as a risk factor for stroke can be much more pronounced in younger people, before common age-related risk factors begin to play a major role in this picture, the authors write.

The analysis of the factors specifically related to HIV infection and its actual weight in the risk of stroke, showed that this amplified viral load peroxide stroke (P = 0.001).

On the other hand, the prolonged duration of antiretroviral therapy (the famous cocktail) (p <0.001) and a viral load lower than 400 copies / ml (p = 0.008) significantly reduced that risk.

We thus demonstrate a new finding: The risk of stroke is broadened in people with HIV in relation to patients in the control group, and that this risk remains relativistic after the introduction of the weight of risk factors traditional, the researchers conclude.

The observed association between virus and stroke should make caregivers and caregivers see HIV as a plausible risk factor for, in a nutshell, a stroke, and further lower the threshold for more intervention aggressive, with the aim of minimizing the risk of tripe vascular system, coronary risk and risk of stroke, especially in women and young people - groups normally not typed to the risk addressed in this study.

Reference

CF Chow et al. Comparison of ischemic stroke Incidence in HIV-infected and non-infected pacientes in the U.S. health care system. J Acquir Immune Defic Synr, onine edition. DOI: 10.1097 / QAI.0b013e31825c7f24, 2012.

Michael Carter

Traduçãopara the Portuguese of Portugal:

GAT - Portuguese Group of Activist Treatments on HIV / AIDS

Adaptation to Portuguese of Brazil: Claudio de Souza Santos

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