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Background: Despite advancements in the management of HIV infection, the factors contributing to stroke development among HIV-positive individuals remain unclear. This systematic review and meta-analysis aim to identify and evaluate the relative risk factors associated with stroke susceptibility in the HIV population.

Methods: A comprehensive search was conducted in PubMed, Scopus, and Web of Science databases to identify studies investigating the risk of stroke development in HIV patients and assessing the role of different risk factors, including hypertension, diabetes, dyslipidemia, smoking, sex, and race. The quality assessment of case-control studies was conducted using the Newcastle-Ottawa Scale, whereas cohort studies were assessed using the National Institute of Health tool. Meta-analyses were performed using a random-effects model to determine pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs).

Results: A total of 18 observational studies involving 116,184 HIV-positive and 3,184,245 HIV-negative patients were included. HIV-positive patients exhibited a significantly higher risk of stroke compared with HIV-negative patients [OR (95% CI): 1.31 (1.20 to 1.44)]. Subgroup analyses revealed increased risks for both ischemic stroke [OR (95% CI): 1.32 (1.19 to 1.46)] and hemorrhagic stroke [OR (95% CI): 1.31 (1.09 to 1.56)]. Pooled adjusted HRs showed a significant association between stroke and HIV positivity (HR: 1.37, 95% CI: 1.22 to 1.54). Among HIV-positive patients with stroke, hypertension [OR (95% CI): 3.5 (1.42 to 8.65)], diabetes [OR (95% CI): 5 (2.12 to 11.95)], hyperlipidemia, smoking, male gender, and black race were associated with an increased risk.

Discussion: Our study revealed a significant increased risk of stroke development among people with HIV. A multitude of factors, encompassing sociodemographic characteristics, racial background, underlying health conditions, and personal behaviors, significantly elevate the risk of stroke in individuals living with HIV. The use of observational studies introduces inherent limitations, and further investigations are necessary to explore the underlying mechanisms of stroke in people with HIV for potential treatment strategies.

Conclusion: HIV patients face a higher risk of stroke development, either ischemic and hemorrhagic strokes. Hypertension, diabetes, hyperlipidemia, smoking, male gender, and black race were identified as significant risk factors. Early identification and management of these risk factors are crucial in reducing stroke incidence among patients living with HIV.

Competing Interests: The authors have no funding or conflicts of interest to disclose.

Titel:	Risk of Stroke Among HIV Patients: A Systematic Review and Meta-analysis of Global Studies and Associated Comorbidities.
Autor/in / Beteiligte Person:	Moawad, MHED ; Mohamed Shalaby, MM ; Hamouda, E ; Mahfouz, A ; Mouffokes, A ; Hamouda, H ; Abbas, A ; Abdelgawad, HAH
Zeitschrift:	Journal of acquired immune deficiency syndromes (1999), Jg. 95 (2024-04-15), Heft 5, S. 399-410
Veröffentlichung:	Hagerstown, MD : Lippincott Williams & Wilkins, Inc., c1999-, 2024
Medientyp:	academicJournal
ISSN:	1944-7884 (electronic)
DOI:	10.1097/QAI.0000000000003382
Schlagwort:	Humans Male HIV Infections complications HIV Infections drug therapy HIV Infections epidemiology Stroke epidemiology Stroke etiology Diabetes Mellitus epidemiology Hypertension complications Hypertension epidemiology Hyperlipidemias
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Meta-Analysis; Systematic Review; Journal Article Language: English [J Acquir Immune Defic Syndr] 2024 Apr 15; Vol. 95 (5), pp. 399-410. MeSH Terms: HIV Infections* / complications ; HIV Infections* / drug therapy ; HIV Infections* / epidemiology ; Stroke* / epidemiology ; Stroke* / etiology ; Diabetes Mellitus* / epidemiology ; Hypertension* / complications ; Hypertension* / epidemiology ; Hyperlipidemias* ; Humans ; Male References: Govender RD, Hashim MJ, Khan MA, et al. Global epidemiology of HIV/AIDS: a resurgence in North America and Europe. J Epidemiol Glob Health. 2021;11:296–301. ; Deeks SG, Overbaugh J, Phillips A, et al. HIV infection. Nat Rev Dis Primers. 2015;1:15035. ; Kemnic TR, Gulick PG. HIV antiretroviral therapy. In: StatPearls. Treasure Island (FL) Ineligible Companies. StatPearls Publishing Copyright © 2023, StatPearls Publishing LLC; 2023. ; Bertrand L, Méroth F, Tournebize M, et al. 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Risk of Stroke Among HIV Patients: A Systematic Review and Meta-analysis of Global Studies and Associated Comorbidities.