Ischemic Cerebrovascular Accidents in HIV Patients on Antiretroviral Therapy: Clinical, Paraclinical And Prognostic Aspects in The Neurology Department of The University Hospital Center of Conakry

Abstract

Introduction: Ischemic stroke (Stroke) constitute, due to the demographic and epidemiological
transition, a real challenge for developing countries and HIV infection, a real public health problem in
these countries. The objective of our study was to describe aspects of clinical, paraclinical and prognostic
ischemic stroke in people living with HIV (PLHIV) on antiretrovirals (ARVs).

Material and methods: This was a prospective study of the descriptive type lasting 6 months from
January 1, 2022 to June 31, 2022, relating to ischemic cerebrovascular accidents (DALYs) in HIV patients
on ARVs.Were included patients admitted or hospitalized in the service for seropositive ischemic stroke
under ARV for an average duration of 35.5 months. Patients recently put on ARVs and those with an
obvious cause of DALY such as (diabetes, uncontrolled hypertension, emboligenic heart disease) were
excluded.

Results: During our study period, 336(94%) patients were listed. Among them, 20 have ischemic stroke
associated with HIV on ARVs, i.e. 6%. This study showed that the average age of onset of ischemic
stroke in PLHIV on ARV was 49 ± 11.6 years with a sex ratio F/M of 1.22. The risk factors were high
blood pressure 13 (65%), diabetes 05 (25%), followed by alcohol 04 (20%). HIV type 1 was represented
at 100%, then 16 (80%) of our patients were at WHO stage III with a CD4 count between 200 and 300
cells/μl09 (45%). The therapeutic line of ARVs was dominated by TDF+3TC+EFV at 14 (70%) followed
by AZT+3TC+LPV/r at 04 (20%) and the average duration of patients on ARV was 35.5 months. The
favorable evolution was marked 13 (65%), followed by a death in (10%) or 02. The location on the
cerebral scanner was dominated by the sylvian artery in 12 (60%) of cases followed by the anterior
cerebral artery (ACA) 06 (30%) and the posterior cerebral artery ( PCA) 02 (10%).

Conclusion: Ischemic stroke in HIV patients on ARVs requires early management and regular
monitoring.