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J Neurovirol. 2016 Oct;22(5):634-640. Epub 2016 Apr 4.

Risk of intracerebral hemorrhage in HIV/AIDS: a systematic review and meta-analysis.

Author information

1
Division of Cerebrovascular Diseases, Department of Neurology, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA. behrouz@uthscsa.edu.
2
Department of Neurology, Medical Arts and Research Center, University of Texas Health Science Center San Antonio, 8300 Floyd Curl Drive, MC 7883, San Antonio, TX, 78229, USA. behrouz@uthscsa.edu.
3
Division of Cerebrovascular Diseases, Department of Neurology, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
4
Department of Neurological Surgery, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
5
Neurological Service, San Camillo de' Lellis General Hospital, Rieti and the Neurological Section, Neuro-epidemiology Unit, SMDN, Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy.

Abstract

Evidence for the association and the increased risk of stroke with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is growing. Recent studies have reported on HIV infection as a potent risk factor for intracerebral hemorrhage (ICH). We used the pooled results from case-control studies to conduct a systematic review and a meta-analysis in order to evaluate the risk of ICH with HIV/AIDS. Our systematic review and meta-analysis was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses algorithm of all available case-control studies that reported on the risk of ICH in patients with HIV/AIDS. Five eligible studies were identified, totaling 5,310,426 person-years studied over various periods that ranged from 1985 to 2010. There were a total of 724 cases of ICH, 138 with HIV/AIDS. HIV-infected ICH patients were in average younger. Pooled crude incidence rate ratio (IRR) for ICH in HIV/AIDS patients was 3.40 (95 % confidence intervals [CI] 1.44-8.04; p = 0.005, random-effects model). Clinical AIDS was associated with a higher IRR of ICH (11.99, 95 % CI 2.84-50.53; p = 0.0007) than HIV+ status without AIDS (1.73, 95 % CI 1.39-2.16; p < 0.0001). Patients with CD4+ lymphocyte count <200 cells/mm3 were similarly at a higher risk. Antiretroviral therapy did not seem to increase the risk of ICH. The available evidence suggests that HIV/AIDS is an important risk factor for ICH, particularly in younger HIV-infected patients and those with advanced disease.

KEYWORDS:

Acquired immunodeficiency syndrome; Human immunodeficiency virus; Intracerebral hemorrhage; Meta-analysis; Stroke

PMID:
27044037
DOI:
10.1007/s13365-016-0439-2
[Indexed for MEDLINE]

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