Traditional vascular risk factors and HIV-related factors can contribute to higher prevalence of ischemic stroke (IS) among HIV-infected patients. Understanding the underlying mechanism of IS could lead to proper management and prognosis. We aimed to determine the prevalence of IS subtypes among HIV-infected patients who were hospitalized due to IS. Medical records of patients who were hospitalized at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between 2008 and 2019 due to first-ever IS with documented HIV infection were retrospectively analyzed. IS subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Among 6,952 patients who were hospitalized due to IS, 50 [0.7% (95% confidence interval: 0.5–1.0)] were HIV-infected patients and were included in the analysis. Common traditional stroke risk factors were dyslipidemia (62%), smoking (55.3%), hypertension (52%), and alcohol consumption (45%). The median (interquartile range) CD4 cell count was 294.5 (186–485) cells/mL and 74% were on antiretroviral therapy. The most common etiology of IS was small vessel occlusion (SVO) (48%), followed by stroke of undetermined etiology (UD) (26%), and stroke of other determined etiology (OD) (14%). Among patients with OD, 5 of 7 were from infectious-related cause. Virologically unsuppressed group had significantly higher proportion of OD (33.3% vs. 3.6%), UD (38.9% vs. 17.9%), and lower proportion of SVO (22.2% vs. 60.7%) based on TOAST classification compared with virologically suppressed group (p = .01). SVO was the most common cause of IS among HIV-infected patients and was more likely to occur among virologically suppressed group, suggesting that traditional vascular risk factors may play a larger role in developing IS. OD was more likely to occur among virologically unsuppressed group, most of which were infectious-related cause.

中文翻译：

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简短交流：泰国 HIV 感染患者的缺血性卒中亚型：一项为期 12 年的回顾性研究

传统的血管危险因素和 HIV 相关因素可能导致 HIV 感染患者中缺血性卒中 (IS) 的患病率较高。了解 IS 的潜在机制可以导致正确的管理和预后。我们旨在确定因 IS 住院的 HIV 感染患者中 IS 亚型的患病率。回顾性分析了 2008 年至 2019 年期间因首次感染艾滋病毒而在泰国曼谷朱拉隆功国王纪念医院住院的患者的医疗记录。IS 亚型根据急性卒中治疗 (TOAST) 分类中的 Org 10172 试验进行分类。在因 IS 住院的 6,952 名患者中，50 [0.7%（95% 置信区间：0.5-1.0）] 是 HIV 感染患者并被纳入分析。常见的传统卒中危险因素是血脂异常 (62%)、吸烟 (55.3%)、高血压 (52%) 和饮酒 (45%)。中位（四分位距）CD4 细胞计数为 294.5 (186–485) 个细胞/mL，74% 接受抗逆转录病毒治疗。IS 最常见的病因是小血管闭塞 (SVO) (48%)，其次是病因不明的卒中 (UD) (26%) 和其他确定病因的卒中 (OD) (14%)。在 OD 患者中，7 名患者中有 5 名来自感染相关原因。与病毒学抑制组相比，基于 TOAST 分类的病毒学未抑制组具有显着更高的 OD（33.3% 对 3.6%）、UD（38.9% 对 17.9%）和更低的 SVO 比例（22.2% 对 60.7%） ( 中位（四分位距）CD4 细胞计数为 294.5 (186–485) 个细胞/mL，74% 接受抗逆转录病毒治疗。IS 最常见的病因是小血管闭塞 (SVO) (48%)，其次是病因不明的卒中 (UD) (26%) 和其他确定病因的卒中 (OD) (14%)。在 OD 患者中，7 名患者中有 5 名来自感染相关原因。与病毒学抑制组相比，基于 TOAST 分类的病毒学未抑制组具有显着更高的 OD（33.3% 对 3.6%）、UD（38.9% 对 17.9%）和更低的 SVO 比例（22.2% 对 60.7%） ( 中位（四分位距）CD4 细胞计数为 294.5 (186–485) 个细胞/mL，74% 接受抗逆转录病毒治疗。IS 最常见的病因是小血管闭塞 (SVO) (48%)，其次是病因不明的卒中 (UD) (26%) 和其他确定病因的卒中 (OD) (14%)。在 OD 患者中，7 名患者中有 5 名来自感染相关原因。与病毒学抑制组相比，基于 TOAST 分类的病毒学未抑制组具有显着更高的 OD（33.3% 对 3.6%）、UD（38.9% 对 17.9%）和更低的 SVO 比例（22.2% 对 60.7%） ( 和其他确定病因 (OD) 的中风 (14%)。在 OD 患者中，7 名患者中有 5 名来自感染相关原因。与病毒学抑制组相比，基于 TOAST 分类的病毒学未抑制组具有显着更高的 OD（33.3% 对 3.6%）、UD（38.9% 对 17.9%）和更低的 SVO 比例（22.2% 对 60.7%） ( 和其他确定病因 (OD) 的中风 (14%)。在 OD 患者中，7 名患者中有 5 名来自感染相关原因。与病毒学抑制组相比，基于 TOAST 分类的病毒学未抑制组具有显着更高的 OD（33.3% 对 3.6%）、UD（38.9% 对 17.9%）和更低的 SVO 比例（22.2% 对 60.7%） (p  = .01）。SVO 是 HIV 感染患者中 IS 的最常见原因，并且更可能发生在病毒学抑制组中，这表明传统的血管危险因素可能在 IS 的发生中发挥更大的作用。OD 更可能发生在病毒学未抑制组中，其中大部分是与感染相关的原因。