HIV status and the risk of ischemic stroke among men

被引：148

作者：

Sico, Jason J. ^{[1
,2
]}

Chang, Chung-Chou H. ^{[3
,4
]}

So-Armah, Kaku ^{[2
]}

Justice, Amy C. ^{[1
,2
]}

Hylek, Elaine ^{[5
]}

Skanderson, Melissa ^{[1
]}

McGinnis, Kathleen ^{[1
]}

Kuller, Lewis H. ^{[4
]}

Kraemer, Kevin L. ^{[3
]}

Rimland, David ^{[6
,7
]}

Goetz, Matthew Bidwell ^{[8
,9
]}

Butt, Adeel A. ^{[3
,10
]}

Rodriguez-Barradas, Maria C. ^{[11
,12
]}

Gibert, Cynthia ^{[13
,14
]}

Leaf, David ^{[8
,9
]}

Brown, Sheldon T. ^{[15
,16
]}

Samet, Jeffrey ^{[17
]}

Kazis, Lewis ^{[18
,19
]}

Bryant, Kendall ^{[20
]}

Freiberg, Matthew S. ^{[21
,22
]}

机构：

[1] West Haven Vet Adm Med Ctr, VA Connecticut Hlth Care Syst, West Haven, CT 06516 USA

[2] Yale Univ, Sch Med, New Haven, CT USA

[3] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA

[4] Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA

[5] Boston Med Ctr, Boston, MA USA

[6] Emory Univ, Sch Med, Atlanta, GA USA

[7] Atlanta Vet Adm Med Ctr, Atlanta, GA USA

[8] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[9] VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA

[10] VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA

[11] Michael E DeBakey Vet Adm Med Ctr, Houston, TX USA

[12] Baylor Coll Med, Houston, TX 77030 USA

[13] Washington DC Vet Adm Med Ctr, Washington, DC USA

[14] George Washington Univ, Sch Med, Washington, DC USA

[15] James J Peters VA, Bronx, NY USA

[16] Mt Sinai Sch Med, New York, NY USA

[17] Boston Univ, Sch Med, Boston, MA 02215 USA

[18] Boston Univ, Ctr Assessment Pharmaceut Practices, Dept Hlth Policy & Management, Sch Publ Hlth, Boston, MA 02215 USA

[19] Vet Adm Med Ctr, Ctr Healthcare Org & Implementat Res, Bedford, MA USA

[20] NIAAA, Bethesda, MD USA

[21] Vanderbilt Univ, Sch Med, Nashville, TN 37212 USA

[22] Nashville Vet Affairs Med Ctr, Nashville, TN USA

来源：

NEUROLOGY | 2015年 / 84卷 / 19期

关键词：

INFECTED PATIENTS; HEALTH; VETERANS; DISEASE; AIDS; YOUNG;

D O I：

10.1212/WNL.0000000000001560

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective:Given conflicting data regarding the association of HIV infection and ischemic stroke risk, we sought to determine whether HIV infection conferred an increased ischemic stroke risk among male veterans.Methods:The Veterans Aging Cohort Study-Virtual Cohort consists of HIV-infected and uninfected veterans in care matched (1:2) for age, sex, race/ethnicity, and clinical site. We analyzed data on 76,835 male participants in the Veterans Aging Cohort Study-Virtual Cohort who were free of baseline cardiovascular disease. We assessed demographics, ischemic stroke risk factors, comorbid diseases, substance use, HIV biomarkers, and incidence of ischemic stroke from October 1, 2003, to December 31, 2009.Results:During a median follow-up period of 5.9 (interquartile range 3.5-6.6) years, there were 910 stroke events (37.4% HIV-infected). Ischemic stroke rates per 1,000 person-years were higher for HIV-infected (2.79, 95% confidence interval 2.51-3.10) than for uninfected veterans (2.24 [2.06-2.43]) (incidence rate ratio 1.25 [1.09-1.43]; p < 0.01). After adjusting for demographics, ischemic stroke risk factors, comorbid diseases, and substance use, the risk of ischemic stroke was higher among male veterans with HIV infection compared with uninfected veterans (hazard ratio 1.17 [1.01-1.36]; p = 0.04).Conclusions:HIV infection is associated with an increased ischemic stroke risk among HIV-infected compared with demographically and behaviorally similar uninfected male veterans.

引用

页码：1933 / 1940

页数：8

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