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Abstract
Objective: Given conflicting data regarding the association of HIV infection and ischemic stroke risk, we sought to determine whether HIV infection conferred an increased ischemic stroke risk among male veterans.
Methods: The Veterans Aging Cohort Study–Virtual Cohort consists of HIV-infected and uninfected veterans in care matched (1:2) for age, sex, race/ethnicity, and clinical site. We analyzed data on 76,835 male participants in the Veterans Aging Cohort Study–Virtual Cohort who were free of baseline cardiovascular disease. We assessed demographics, ischemic stroke risk factors, comorbid diseases, substance use, HIV biomarkers, and incidence of ischemic stroke from October 1, 2003, to December 31, 2009.
Results: During a median follow-up period of 5.9 (interquartile range 3.5–6.6) years, there were 910 stroke events (37.4% HIV-infected). Ischemic stroke rates per 1,000 person-years were higher for HIV-infected (2.79, 95% confidence interval 2.51–3.10) than for uninfected veterans (2.24 [2.06–2.43]) (incidence rate ratio 1.25 [1.09–1.43]; p < 0.01). After adjusting for demographics, ischemic stroke risk factors, comorbid diseases, and substance use, the risk of ischemic stroke was higher among male veterans with HIV infection compared with uninfected veterans (hazard ratio 1.17 [1.01–1.36]; p = 0.04).
Conclusions: HIV infection is associated with an increased ischemic stroke risk among HIV-infected compared with demographically and behaviorally similar uninfected male veterans.
GLOSSARY
- CI=
- confidence interval;
- CVD=
- cardiovascular disease;
- HAART=
- highly active antiretroviral therapy;
- HCV=
- hepatitis C virus;
- HMG-CoA=
- 3-hydroxy-3-methylglutaryl–coenzyme A;
- HR=
- hazard ratio;
- ICD-9=
- International Classification of Diseases, Ninth Revision;
- ICD-9-CM=
- International Classification of Diseases, Ninth Revision, Clinical Modification;
- VA=
- Veterans Affairs;
- VACS-VC=
- Veterans Aging Cohort Study–Virtual Cohort
Footnotes
Veterans Aging Cohort Study coinvestigators are listed on the Neurology® Web site at Neurology.org.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received September 18, 2014.
- Accepted in final form January 29, 2015.
- © 2015 American Academy of Neurology
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