Human Immunodeficiency Virus (HIV) and Stroke Events: A Systematic Review and Meta-Analysis

Stroke is a very disabling state that affects a considerable number of people around the world and it has been associated with human immunodeficiency (HIV) infection. However, there is no comprehensive review article in the literature that well investigates this critical topic. So, we performed this systematic review using Pubmed search. From 655 studies found at the initial search using broad Mesh terms and after exclusion studies of unrelated topics or out of criteria, 39 studies have been left and reviewed. During over 1.2 million person-years of follow up, a broad spectrum of incidence rate of stroke events has been reported by different authors from 0.73/1000 to 5.27/1000 person years of follow up in different cohort studies. About the anatomical regions of the brain which are complicated by HIV infection, circle of Willis and basal structures including basal ganglia and thalamus seem to be more affected. The range of risk factors which have been associated with stroke events in HIV infected patients is too much wide and includes controversy: younger age, gender, hemorrhagic (vs. ischemic) stroke, antiretroviral therapy are the major factors with controversial factors associated with higher or lower stroke events in HIV infected individuals.on the other hand there were factors constantly reported as risk factors of higher stroke events in HIV positive patients which included CD4 cell counts, having AIDS, diabetes, being smoker, and not having arterial hypertension. Future controlled studies with large study populations can better clarify these risk factors.