Stroke Outcomes With and Without HIV Compared

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here were no significant differences between the 2 groups with regard to length of hospital stay, comorbid conditions, stroke severity, or inpatient mortality rates.
here were no significant differences between the 2 groups with regard to length of hospital stay, comorbid conditions, stroke severity, or inpatient mortality rates.

SAN DIEGO — Patients with HIV have similar stroke outcomes and comorbid conditions compared with older patients who are HIV negative, according to data presented at IDWeek 2017.

Investigators analyzed data from the Stroke Management and Rehabilitation Team patient-level database at Barnes-Jewish Hospital in St. Louis, Missouri, which included adult patients hospitalized with a first stroke episode. Of 20,268 patients included in the analysis, a total of 81 were infected with HIV. At stroke presentation, approximately 38% of infected patients had an HIV viral load <200 copies/mL, and the median CD4+ count was 148 cells/μL.

On average, those with HIV were younger than non-infected patients (49 vs 65 years, respectively; P =.010). In addition, significantly more of those with HIV were black (66% vs 39%; P <.001), more likely to smoke (57% vs 29%; P <.001), and more likely to use alcohol (17% vs 7%; P <.001) and illicit drugs (30% vs 5%; P <.001). There were no significant differences between the 2 groups with regard to length of hospital stay, comorbid conditions, stroke severity, or inpatient mortality rates.

Between 1999 and 2016, the age of patients infected with HIV significantly increased (r =0.40, P <.010); however, age did not change for non-infected patients. Additionally, the HIV viral load at presentation appeared to decline over time (r =-0.53, P <.001).

“Our finding that HIV-infected patients present with stroke at older ages and with lower viral load over time suggests a potential change in the pathogenesis of stroke from viral-driven processes to more aging-related risk factors,” the investigators concluded.

Disclosures: Dr Ances serves on the editorial board of the Journal of Neurovirology. No other conflicts of interest to report. 

Reference

McBride II D, Hu Q, Wong A, et al. Stroke outcomes among HIV-infected patients in a large, urban, tertiary hospital in the United States, 1999-2016. Presented at: IDWeek 2017; October 4-8, 2017; San Diego, CA. Poster 548. 

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