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|Title: ||Risk factors for stroke occurrence in a low HIV endemic West African country: A case-control study|
|Authors: ||Sarfo, Fred Stephen|
Low HIV prevalence
|Issue Date: ||2018|
|Publisher: ||Journal of the Neurological Sciences|
|Citation: ||Journal of the Neurological Sciences, 395 (2018) 8–16|
|Abstract: ||Background: HIV infection is an emerging vascular risk factor associated with stroke occurrence. The weight of
evidence from sub-Saharan Africa in support of this has accrued from countries with high HIV prevalence. Our
objective was to assess the contribution of HIV sero-positivity to the occurrence and outcomes of stroke in a West
African country with low HIV prevalence.
Methods: A case-control study design conducted at a tertiary medical center in Ghana involved in the Stroke
Investigative Research & Educational Networks (SIREN) epidemiological study. Stroke cases were adults (aged
≥18 years) with CT or MRI confirmed stroke and stroke-free controls were age-matched and recruited from
communities in the catchment areas of cases. Standard instruments were used to assess vascular and lifestyle
factors and serological screening for HIV antibodies was conducted for all study participants. Stroke patients
were followed for in-patient mortality outcomes. Associations between HIV, demographic and vascular risk
factors and stroke occurrence and outcomes were assessed using logistic regression analysis.
Results: We enrolled 540 stroke cases and 540 control subjects with a mean (±SD) age of 60.8 ± 15.5 years
(cases) and 60.0 ± 15.5 (controls). Among stroke cases, the frequency of HIV was 12/540 (2.2%, 95% CI: 1.3%
- 3.6%) versus 15/540 (2.8%, 95% CI: 1.7% - 4.6%) among stroke-free controls, p=.70. However, the median
(IQR) age of Persons Living with HIV (PLWH) with stroke was significantly lower at 46.5 (40–65.3) years versus
61.0 (50–74) years, p=.03 among HIV- stroke patients. Stroke among PLWHA was predominantly hemorrhagic
in 7 out of 12 cases and ischemic in 5 of 12 with notable clustering of established factors such as hypertension,
(100%), dyslipidemia, 83.3%, central obesity, 50.0%, diabetes mellitus, 33.3%, cardiac diseases, 8.3% in this
group. None of the PLWH with stroke were receiving antiretroviral therapy.
Conclusion: We found no associations between HIV infection and stroke occurrence among Ghanaians. However
a clustering of cardio-metabolic factors in the context of HIV may promote stroke occurrence in younger individuals.|
|Description: ||An article published in Journal of the Neurological Sciences, 395 (2018) 8–16|
|Appears in Collections:||College of Health Sciences|
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