Gender variation in the risk of stroke among HIV- infected patients in north-eastern Nigeria.

Abstract

Recent Epidemiologic evidence suggested that Acquired Immunodeficiency Syndrome (AIDS) increases the chances of suffering from stroke, several literatures contained reports of thrombotic episodes occurring in patients with HIV infection; and various abnormalities predisposing to a hypercoagulable state have also been reported in such patients. Risk of stroke in non-HlV patients is higher in men than in women when considering individuals younger than age 80 years. However, few data exist to quantify the role of gender variation in the risk of stroke among HIV- infected stroke patients especially in the study area; the aim of this study was to find out if the baseline variables, including gender play a significant role in the risk of stroke among HIV- Infected stroke patients. Method: This was a Hospital based case-control study. Sixty-five (65) stroke patients aged 20-68 years and sixty-five (65) age and sex matched controls were enrolled. A structured questionnaire was administered. Neurological examination was performed and computed tomography scan of the Brain done. Blood samples were taken for HIV 1& 2 screening using DETERMINE kit ELISA method. Double ELISA confirmed positive results. CD4 count was determined by flow cy tome try and serum chemistry was also carried out. Results: The risk of HIV infection among stroke cases was significantly higher than in control subjects 13 (20%) versus 3 (4.6%), respectively; (p-value <0.008). Odds ratio for HIV infection among stroke patients was 5.17. Statistical analyses of other variables showed that, female gender; young age and low CD, count were significantly associated with the risk of developing ischaemic stroke. Conclusion: Human Immunodeficiency virus infection is a significant risk factor for ischaemic stroke in the adult population of Northeastern Nigeria and that, the female preponderance as well as, the low mean CD, count among HIV Sero-positive stroke patients in this study reflect the demography of HIV in our Hospital. Therefore, considering HIV in the differential diagnosis of ischaemic stroke of unknown origin especially in young female adults is worthwhile in Northeastern Nigeria and that, further methodologically sound studies are needed to better define the epidemiology of AlDS-associated cerebrovascular disease in the Nigerian population