Original Paper

Stroke in HIV-Infected Patients: A Clinical Perspective
Alejandro A. Rabinstein

Department of Neurology, University of Miami School of Medicine, Miami, Fla., USA

Address of Corresponding Author

Cerebrovasc Dis 2003;15:37-44 (DOI: 10.1159/000067120)

  Key Words

• Stroke
• HIV
• Protease inhibitors
• Vasculopathy

  Abstract

The occurrence of stroke in patients with human immunodeficiency virus (HIV) infection has been traditionally associated with opportunistic infections and tumors, and advanced stages of immunosuppression. However, this reality is undergoing major changes. Effective antiretroviral regimens are now able to forestall the progression of HIV infection and avoid early mortality. As HIV-infected patients are growing older, clinicians are facing new challenges, including an increasing incidence of vascular complications. The use of protease inhibitors is associated with a variety of metabolic derangements that could produce accelerated atherosclerosis. Cerebrovascular hemodynamic function is impaired in HIV-infected patients with evidence of abnormal vasoreactivity even in otherwise healthy individuals. The potential contribution from these novel mechanisms should be added to the high incidence of classic vascular risk factors in the HIV-infected population and the cardiac abnormalities frequently observed in these patients. Large-scale epidemiological studies should be carried out to define the true incidence of stroke in HIV-infected patients and the factors associated with its occurrence.

Copyright © 2003 S. Karger AG, Basel

  Author Contacts

Alejandro A. Rabinstein, MD
University of Miami School of Medicine (D4-5)
PO Box 016960
Miami, FL 33124 (USA)
Tel. +1 305 243 7519, Fax +1 305 243 7525, E-Mail alerabas@yahoo.com

  Article Information

Received: Received: November 9, 2001
Accepted: April 24, 2002
Number of Figures : 0, Number of Tables : 1, Number of References : 72