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Neurology. 2014 Nov 4;83(19):1705-11. doi: 10.1212/WNL.0000000000000958. Epub 2014 Oct 3.

Elevated rates of intracerebral hemorrhage in individuals from a US clinical care HIV cohort.

Author information

1
From the Departments of Neurology (F.C.C.) and Epidemiology and Biostatistics (P.B.), University of California San Francisco; the Department of Neurology (S.K.F.), Brigham and Women's Hospital, Boston; and the Division of General Medicine (W.H., S.R., J.B.M., V.A.T.), Program in Nutritional Metabolism (S.K.G., V.A.T.), and Division of Infectious Diseases (V.A.T.), Massachusetts General Hospital, Boston. chowf@sfgh.ucsf.edu.
2
From the Departments of Neurology (F.C.C.) and Epidemiology and Biostatistics (P.B.), University of California San Francisco; the Department of Neurology (S.K.F.), Brigham and Women's Hospital, Boston; and the Division of General Medicine (W.H., S.R., J.B.M., V.A.T.), Program in Nutritional Metabolism (S.K.G., V.A.T.), and Division of Infectious Diseases (V.A.T.), Massachusetts General Hospital, Boston.

Abstract

OBJECTIVE:

To compare rates of intracerebral hemorrhage (ICH) in HIV-infected and uninfected individuals in a large clinical care cohort and to assess risk factors associated with ICH.

METHODS:

We identified incident ICH in HIV-infected and uninfected control cohorts from the Partners Health Care system using ICD-9-CM codes. We constructed Cox proportional hazards models to estimate adjusted hazard ratios for HIV infection and other predictors of ICH.

RESULTS:

The incidence rate of ICH was 2.29 per 1,000 person-years in HIV-infected individuals compared with 1.23 per 1,000 person-years in uninfected individuals, with an unadjusted incidence rate ratio of 1.85 (95% confidence interval 1.37-2.47, p < 0.001). In a multivariable model, HIV infection was independently associated with a higher hazard of ICH, although its effect diminished with increasing age. Female sex was associated with a lower hazard of ICH in the uninfected cohort but not in the HIV cohort. CD4 count <200 × 10(6) cells/L and anticoagulant use were predictive of ICH.

CONCLUSIONS:

HIV infection conferred an increased adjusted hazard of ICH, which was more pronounced in young patients and in women.

PMID:
25280902
PMCID:
PMC4239837
DOI:
10.1212/WNL.0000000000000958
[Indexed for MEDLINE]
Free PMC Article

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