HIV infection and stroke:current perspectives and future directions

Benjamin, Laura A. and Bryer, Alan and Emsley, Hedley C. A. and Khoo, Saye and Solomon, Tom and Connor, Myles D. (2012) HIV infection and stroke:current perspectives and future directions. Lancet Neurology, 11 (10). pp. 878-890. ISSN 1474-4422

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HIV infection can result in stroke via several mechanisms, including opportunistic infection, vasculopathy, cardioembolism, and coagulopathy. However, the occurrence of stroke and HIV infection might often be coincidental. HIV-associated vasculopathy describes various cerebrovascular changes, including stenosis and aneurysm formation, vasculitis, and accelerated atherosclerosis, and might be caused directly or indirectly by HIV infection, although the mechanisms are controversial. HIV and associated infections contribute to chronic inflammation. Combination antiretroviral therapies (cART) are clearly beneficial, but can be atherogenic and could increase stroke risk. cART can prolong life, increasing the size of the ageing population at risk of stroke. Stroke management and prevention should include identification and treatment of the specific cause of stroke and stroke risk factors, and judicious adjustment of the cART regimen. Epidemiological, clinical, biological, and autopsy studies of risk, the pathogenesis of HIV-associated vasculopathy (particularly of arterial endothelial damage), the long-term effects of cART, and ideal stroke treatment in patients with HIV are needed, as are antiretrovirals that are without vascular risk.

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Journal Article
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Lancet Neurology
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06 Feb 2017 12:00
Last Modified:
18 Sep 2023 01:09