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Ischemic Stroke and TIA

  • Felicia C. ChowEmail author
Chapter

Abstract

As persons living with HIV infection (PLWH) reach older age, the intersection of the global stroke and HIV epidemics may pose a significant public health challenge. HIV infection is an independent risk factor for ischemic stroke, conferring an estimated 20–60% additional risk. When a person with HIV infection presents with an ischemic stroke or transient ischemic attack, confirmation of the patient’s HIV treatment and immune status is essential and will help to guide clinical decisions regarding the indicated evaluation. Black race and female sex are associated with higher stroke rates among PLWH; research geared toward understanding the root cause of and addressing these health disparities should be a top priority. Providers should be aware of potential limitations of cardiovascular risk prediction models when applied to PLWH. In addition, mindfulness of both established and nontraditional stroke risk factors, including those that may be more common in or specific to individuals living with HIV infection (e.g., cardiometabolic toxicities of ART, chronic HIV-associated immune activation, and inflammation), is crucial in providing high-quality cerebrovascular care for PLWH.

Keywords

Ischemic stroke TIA Infarct Cerebrovascular disease HIV infection 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Neurology, Zuckerberg San Francisco General HospitalUniversity of CaliforniaSan FranciscoUSA
  2. 2.Department of Medicine (Infectious Diseases)University of CaliforniaSan FranciscoUSA

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