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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Incidence and clinical features of cerebrovascular disease among HIV-infected adults in the southeastern United States
AIDS Research and Human Retroviruses, Volume 29, No. 7, Year 2013
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Description
With aging of the HIV-infected population, non-AIDS conditions such as cardiovascular disease (CVD) now account for substantial mortality and morbidity. While myocardial infarction is the major outcome of interest in the field of HIV and CVD, cerebrovascular disease remains understudied, especially in the Southeastern United States. We determined the incidence and clinical features of cerebrovascular events (CVE) in a large HIV clinical cohort in North Carolina (NC). A total of 2,515 HIV-infected adults contributed a median of 4.5 years (IQR: 2.0, 7.8) of follow-up. Fifty-three CVEs were adjudicated for an incidence rate of 3.87 per 1,000 person-years (95% CI: 2.90, 5.06). The ischemic stroke incidence was 2.26 per 1,000 person-years (95% CI: 1.53, 3.21), approximately 1.5 times the rate of a population-based cohort in NC. At the time of CVE, the median age was 48 years (IQR: 42, 55). Of ischemic strokes 76% resulted from large artery atherosclerosis or small vessel (lacunar) disease. In multivariable analyses, age, hypertension, dyslipidemia, recent CD4+ cell count ≤200 cells/mm3, and recent HIV RNA >400 copies/ml were associated with an increased risk of CVE. Antiretroviral therapy (ART) was not associated with the risk of CVE. We concluded that in the post-ART era, HIV-infected individuals appear to be at moderately increased risk of stroke. Prevention of CVEs in this population will require modification of traditional CVD risk factors and early, effective treatment of HIV infection. © 2013, Mary Ann Liebert, Inc.
Authors & Co-Authors
Vinikoor, Michael J.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Napravnik, Sonia
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Huang, David Y.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Eron, Joseph J.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Statistics
Citations: 69
Authors: 4
Affiliations: 1
Identifiers
Doi:
10.1089/aid.2012.0334
ISSN:
19318405
Research Areas
Infectious Diseases
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study