The rate of stroke is increasing in most of sub-Saharan Africa. In some countries, a very substantial proportion of stroke patients are young adults. And they have a low prevalence of established risk factors such as high blood pressure, diabetes, obesity and smoking.
Recently, a new study discovered that HIV infection is the leading risk factor for stroke in young African adults. The researchers have investigated the role of HIV, its treatment, and its interaction with high blood pressure as risk factors for stroke in Malawian adults.
In a case-controlled study of 222 stroke patients and 503 controls, the researchers discovered that up to 42% of cases in those under the age of 45 could be attributed to HIV infection. And there was no interaction between stroke and high blood pressure in young adults, which demonstrated that HIV infection is an independent risk factor.
On the other hand, the study demonstrated that treatment for HIV affected the risk of stroke with patients in their first six months on antiretroviral therapy (ART) at the highest risk. There was also no association with HIV and high blood pressure.
The findings revealed the link between HIV infection and stroke is now more convincing than ever. While in the longer term treatment reduces stroke risk, the researchers surprisely found that the risk actually increases in the first few months of therapy.
The research team note that this increased risk of stroke found in those starting treatment poses an additional, but potentially treatable, problem. The findings of the research show that we need to rethink carefully how to develop HIV treatment. Further study is needed to address this question.
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