HIV and Stroke: A Dual Burden in Sub-Saharan Africa

In a case-control study from Malawi, HIV infection was associated with stroke, independent of hypertension, and was the predominant stroke risk factor in adults age 45 years or younger.

In sub-Saharan Africa, the HIV-infection and stroke epidemics are progressing in parallel. Given that HIV infection has been a stroke risk factor in U.S. cohorts (NEJM JW AIDS Clin Care Dec 2012 and J Acquir Immune Defic Syndr 2012; 60:351), investigators prospectively studied 222 adults hospitalized with stroke in Malawi (86% MRI-confirmed) and 503 population-based matched controls. The population-attributable fraction (PAF) was used to quantify the independent contributions of stroke risk factors.

The main findings:

HIV infection was significantly associated with stroke (PAF, 15%), independent of the contribution of hypertension (PAF, 46%).
HIV infection was the predominant stroke risk factor in adults aged ≤45 years (adjusted odds ratio, 5.…

Reviewing Authors

Virginia Triant, MD, MPH

Rajesh T. Gandhi, MD

Disclosures

Grant/Research SupportNIH

Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)

Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)