The structure of stroke and the effect of somatic and addiction diseases on its appearance and course in patients with HIV infection

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OBJECTIVE

To study the contribution of somatic and addiction diseases to the formation and course of acute cerebrovascular accidents in people with HIV infection.

MATERIAL AND METHODS

The study included 123 patients with HIV infection, aged 27 to 86 years, who were treated in the primary vascular departments of hospitals in the Tyumen region in the period from 2013 to 2019. The patients were divided into two groups corresponding to the typology of stroke. All patients underwent a comprehensive neurological examination, laboratory and instrumental studies, including neuroimaging methods.

RESULTS

In the group of patients with ischemic stroke, arterial hypertension was observed in 91.1% of cases, and with intracranial hemorrhages — in 66.7%. This risk factor was associated with a fatal outcome in 59.0% of patients with hemorrhages. Among those who died from cerebral infarction, 8.0% of patients suffered from hypertension, and 67.0% of them were men. Concomitant bronchopulmonary pathology in the vast majority of cases increased the risk of ischemic stroke in patients (93.0% of cases), and the presence of pneumonia in the acute period of a stroke significantly increases the risk of death. In addition, 45.5% of patients had comorbid viral hepatitis C (HCV). In this group of patients, 64.0% had an ischemic type of stroke, and 36% had hemorrhage. There were no deaths in patients with ischemic stroke, HIV and HCV, and among patients with hemorrhages and the same viral diseases, the mortality rate was 50.0%.

CONCLUSION

The study showed a greater effect of hypertension on the risk of ischemic stroke than on the risk of intracranial hemorrhage in the study group of patients, which is an inverse relationship than the effect of this factor on the risk of stroke in HIV-negative patients. The presence of hepatitis C in an HIV-infected patient with a stroke increases the likelihood of death from intracranial hemorrhage.

Keywords:

HIV infection

ischemic stroke

hemorrhagic stroke

drug addiction

stroke mortality

Authors:

Tarasov D.O.

Tyumen State Medical University

Lebedev I.A.

Tyumen State Medical University

Nekrasov D.A.

Regional clinical hospital No. 2

Verbakh T.E.

Tyumen State Medical University

Nesterova O.A.

Tyumen State Medical University

Received:

03.03.2022

Accepted:

18.03.2022

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