STROKE IN PATIENTS WITH HIV INFECTION

Introduction. In patients with HIV infection frequency lesions of the nervous system stage in second place after the immune system, at the same time, strokes account for 1–5% of all lesions of the nervous system in HIV infection. The incidence of strokes in people under the age of 45 with AIDS is 10 times higher than in general population of people at the same age. Supposed that the role of HIV-associated vasculopathy and opportunistic infections is increasing the risk of stroke. The purpose of the study was to study features course of stroke in patients with HIV infection, hospitalized to vascular centers, depending on the type of stroke and identifications risk factors of cerebrovascular diseases (CeVD). Materials and methods. Studies were conducted in 73 patients with stroke, hospitalized for emergency reasons in vascular centers of St. Petersburg. In 33 (45,2%) patients was identified HIV infection, average age 49±11 years (group 1); 40 (54,8%) people without HIV infection, average age 49±7 years made up group 2. Depending on the type of stroke, hemorrhagic (HS) or ischemic stroke (IS), groups 1 and 2 were divided into subgroups. All patients were examined according to сase management program, which provides clinical, laboratory, neuroradiological, ultrasound research methods. HIV-infection was identified by laboratory research methods — ELISA and immunoblotting with determination of antigens and antibodies to HIV. Stages of HIV infection were determined according to the classification of V. I. Pokrovsky in a modification of the Federal scientific and methodological center for the prevention and control of AIDS. Results. This study was to identify the prevalence in group 1 proportion of patients with 3rd stage of HIV infection. Hemorrhagic stroke in the 1st group was characterized by a meningeal syndrome and thrombocytopenia, ischemic stroke (IS) — headache syndrome, lymphopenia, thrombocytopenia, increased ESR, ALT and AST enzymes, and smaller proportion of cardioembolic strokes, also insignificant regression compared neurological symptoms in patients without HIV infection (p<0,05). Conclusion. The most significant risk factors of CeVD in patients with HIV infected are diseases of the cardiovascular system with a smaller proportion of patients with coronary heart disease in patients with IS and cerebral arteriosclerosis. We can assume a significant role of the pathogenic effect HIV on hemostatic system and vascular endothelium, on increasing the risk of developing vascular accidents in patients with HIV infection. Smaller regression of neurological symptoms and hard course of disease in HIV infection associated with secondary opportunistic diseases, co-infections, late hospital admissions, hemostasiological disorders and in most cases the absence of HAART.

hemorrhagic stroke, ischemic stroke, HIV infection, risk factors of CeVD

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