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AIDS increases risk of stroke
  NEW YORK (Reuters Health) - Patients with AIDS who have not received highly active antiretroviral therapy (HAART) are at greatly increased risk for both ischemic stroke and intracerebral hemorrhage, reinforcing theories that HIV induces a prothrombotic state or induces vasculopathy.
Although the relationship between AIDS and stroke has been suggested, no studies have quantified the risk within a defined population, Dr. John W. Cole and associates note in the January issue of Stroke, Journal of the American Heart Association.
The group abstracted information from records of patients ages 15 to 44 with stroke in 1988 and in 1991 -- before the availability of HAART -- included in the Baltimore-Washington Cooperative Young Stroke Study.
There were 386 ischemic strokes and 171 cases of intracerebral hemorrhage. In both categories, six patients were diagnosed with AIDS (2.2%). Those with AIDS did not differ significantly from those without AIDS in terms of traditional risk factors.
The relative risk of stroke adjusted for age, race, and gender was 17.8 for those with AIDS. When the authors excluded five cases in which other potential causes of stroke were identified, the relative risk of 10.4 was still quite high.
"Our findings are relevant to most AIDS patients worldwide who do not have access to HAART," Dr. Cole's team suggests. Their findings provide a baseline for comparing the risk of stroke when patients are treated with HAART.
Stroke 2004;35:51-56.
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