21 January 2011
A new study of stroke in the United States has found that the rate of brain-damaging blood clots has increased dramatically among people infected with HIV. The increase in strokes coincides with the use of newer, more effective AIDS medicines.
Bruce Ovbiagele of the University of California, San Diego, and his colleagues analyzed a database of medical records for the decade starting in 1997.
During that period, hospitalizations for stroke in the U.S. declined by seven percent. "But when you look in the HIV population," Ovbiagele said, "they actually increased almost about 60 percent across the decade. So stroke rates were going up among HIV-infected individuals while they were going down in the general population."
The scientist says the data used in this study is not sufficient to explain definitively why strokes increased in people with HIV. But he believes it's not a coincidence that the surge in strokes came just as HIV patients began using more powerful drugs known as highly active antiretroviral therapies, or HAART medications.
"Now we know that HAART medications have metabolic complication, which include abnormal changes in cholesterol, unfavorable changes in cholesterol. We know that they can also cause increased deposition of fat within the body. And both these things are risk factors for stroke."
Ovbiagele says his study suggests that HIV-positive individuals and their doctors have to be vigilant and proactive to reduce the risk of stroke.
"Screening for high blood pressure should be regular and frequent and treated promptly," he said in a telephone interview. "Screening for high cholesterol should be regular, frequent, and treated promptly. So these are the kinds of things that clinicians and patients should be vigilant about looking for to try and avert a stroke from occurring."
This data was limited to U.S. patients, so he says it's not possible to say if the same pattern of strokes among people with HIV is present in other countries.