Relationship between Younger Age, Autoimmunity, Cardiometabolic Risk, Oxidative Stress, HAART, and Ischemic Stroke in Africans with HIV/AIDS

Abstract

Background and Purpose. It now appears clear that both HIV/AIDS and antiretroviral therapy (HAART) use are associated with higher risk of cardiovascular disease such as stroke. In this study, we evaluated the prevalence, the risk factors, and the cardiometabolic comorbidities of stroke in HIV/AIDS Central African patients. Methods. This hospital-based cross-sectional study collected clinical, laboratory, and imaging data of black Central African heterosexual, intravenous drug nonuser, and HIV/AIDS patients. Results. There were 54 men and 62 women, with a female to male ratio of 1.2 : 1. All were defined by hypercoagulability and oxidative stress. Hemorrhagic stroke was reported in 1 patient, ischemic stroke in 17 patients, and all stroke subtypes in 18 patients (15%). Younger age <45 years (P = .003), autoimmunity (P < .0001), and metabolic syndrome defined by IDF criteria (P < .0001) were associated with ischemic stroke. Conclusions. Clustering of several cardiometabolic factors, autoimmunity, oxidative stress, and lifestyle changes may explain accelerated atherosclerosis and high risk of stroke in these young black Africans with HIV/AIDS. Prevention and intervention programs are needed.

Prevalence and risk factors of metabolic syndrome in HIV‐infected adults at three urban clinics in a post‐conflict setting, eastern Democratic Republic of the Congo

“…Our findings have several clinical and public health implications. As seen in other studies in Africa [27,29,49], PLHIV are younger and facing the additional burden of non-communicable diseases. There is an urgent need to implement CVD prevention and management strategies in HIV-infected patients.…”

Stroke subtypes and factors associated with ischemic stroke in Kinshasa, Central Africa

“…The rates of the disease which were considerably lower, are now rapidly increasing, even doubling in regions such as rural South Africa [4][5] . The reasons for the high burden of stroke are linked to the high rates of chronic hypertension, type 2 diabetes mellitus (T2DM), excessive alcohol intake, smoking, insufficient fruit and vegetable consumption [6][7][8] , sickle cell disease, HIV infection and even antiretroviral drugs 9 . Also, ischemic stroke is more suffered than hemorrhagic stroke 10,11 .…”

HIV Infection and Acute Stroke: A Case Report and a Review of the Literature

“…This concern was validated by several reports; the French Hospital Database on HIV found that patients who had been treated with protease inhibitor for 18 months or more had twice the risk of myocardial infarction that was seen among patients with less drug exposure [3]. A cross-sectional study carried out on HIV-infected patients had shown that stroke in patients with HIV/AIDS was not associated with opportunistic infections and tumors, and early assessment of the vascular status was recommended [4]. We are presenting the case of HIV-infected young patient with acute stroke to discuss the risk factors of cardiovascular events in patients with HIV infection on ART as stroke is a rising cause of disability in HIV and AIDS populations.…”