Department of Neurology, University of California, San Francisco, California.
Semin Neurol. 2014 Feb;34(1):35-46. doi: 10.1055/s-0034-1372341. Epub 2014 Apr 8.
With the transformation of HIV infection into a chronic disease for the majority of patients with access to combination antiretroviral therapy, HIV-infected individuals and their medical providers are facing a new set of challenges, many of which are more typical of an aging population. Accumulating evidence indicates that rates of stroke, like coronary heart disease, may be higher in HIV-infected individuals. This review will discuss the epidemiology of stroke in HIV infection, potential mechanisms underlying the pathogenesis of stroke, vascular risk and cognitive impairment, cardiovascular and stroke risk prediction, and strategies for stroke prevention in this at-risk population, with a focus on HIV-associated cerebrovascular disease in the current era of highly effective combination antiretroviral therapy.
随着大多数接受联合抗逆转录病毒疗法的 HIV 感染者转变为慢性疾病，HIV 感染者及其医疗服务提供者面临着一系列新的挑战，其中许多挑战更类似于老龄化人口所面临的挑战。越来越多的证据表明，HIV 感染者的中风发生率与冠心病相似，可能更高。本综述将讨论 HIV 感染患者中风的流行病学、中风发病机制的潜在机制、血管风险和认知障碍、心血管和中风风险预测，以及在当前高效联合抗逆转录病毒治疗时代针对这一高危人群预防中风的策略，重点关注与 HIV 相关的脑血管疾病。
