Article
Author(s):
People living with HIV have known greater rates of stroke, but the reason for that risk was the focus of an abstract presented last week at IAS 2021, this year's virtual annual meeting of the International AIDS Society, which took place July 18 to 21.
People living with HIV have known greater rates of stroke, but the reason for that risk was the focus of an abstract presented last week at IAS 2021, this year's virtual annual meeting of the International AIDS Society, which took place July 18 to 21.
“Even after accounting for traditional risk factors and HIV-related variables, ischemic stroke remains up to 65% higher for persons living with HIV,” the investigators wrote.
Stress, as it relates to neural inflammatory pathways, may be the reason why, they believe, so they investigated “the relationship between stress, metabolic activity in stress-related brain regions, and arterial inflammation on 18F-fluorodeoxyglucose (FDG)-PET [positron emission tomography], the latter being predictive of ischemic stroke and other CVD events.”
Overall, the authors analyses (Voxelwise group comparisons and linear regression analyses) showed the following associations:
In addition, the following metabolic activity ranges were seen in the regions—entorhinal cortex, amygdala, hippocampi, carotid—of the brain evaluated:
The Perceived Stress Scale, Chronic Burden Scale, PTSD Checklist-Civilian, HIV Stigma Scale, and Patient Health Questionnaire-9 were used to gauge stress, as was total adverse childhood experiences.
Among their study cohort of 32 persons living with an undetectable HIV viral load (≤ 40 copies/mL) who underwent FDG-PET and clinical and neuropsychiatric testing, the mean (SD) age was 60 (7) years, and 97% were assigned male sex at birth. Most (78%) were non-Hispanic White, and 88% had been living with HIV for a median 29 years. Their top 5 cardiovascular risk factors were hyperlipidemia (78%), aspirin/statin use (66%), any current alcohol use (59%), current/prior cocaine use (59%), and hypertension (53%). There were also 30 age- and sex-matched controls who were not living with HIV.
“These findings warrant further investigation into the mechanisms by which stress and brain metabolic activity in stress-responsive regions are associated with greater arterial inflammation in people living with HIV,” the authors concluded.
Reference
Chow FC, Strom A, Abohashem S, et al. Psychological stress is associated with carotid inflammation in persons with treated HIV infection. Presented at: IAS 2021; July 18-21, 2021. Accessed July 23, 2021. https://conference.ias2021.org/media-391-psychological-stress-is-associated-with-carotid-inflammation-in-persons-with-treated-hiv-i
From Criminalization to Compassion: The Evolution of HIV Laws