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Depression linked to increased stroke risk in some people with HIV

Due to social and biological factors, depression is relatively common in people with HIV. Some studies have found that there is a greater risk of stroke in people with HIV compared to people without HIV.

In the present study, clinics with nearly 14,000 people with HIV pooled their databases and monitored reports of stroke that occurred over eight years. Neurologists reviewed medical records to be certain that strokes occurred. Participants were regularly screened for depression using standardized surveys.

At the start of the study, the average profile of participants was as follows:

  • age – 45 years
  • 81% male, 19% female
  • a majority of participants (58%) were people of colour and 42% were White
  • comorbidities – 13% had elevated cholesterol that was being treated and 26% had high blood pressure that was being treated
  • substance use – 64% used alcohol; 38% used tobacco; 8% used methamphetamine; 7% used cocaine
  • 23% had symptoms of depression

Results

Over the study, 173 participants had a stroke.

Statistical analysis found that, overall, people who had depression were 16% more likely to have a stroke. This connection between depression and stroke risk was limited to people younger than 50 years old. There was a trend among young people who had greater severity in depression to have a greater risk of stroke. There was no difference in stroke risk by sex.

Bear in mind

The link between depression and stroke risk is likely complex. It may be that younger people are more likely to have inflammation that increases their risk of stroke. The researchers argue that there are factors that need further analysis, such as those related to sociodemographics, HIV and substance use. It is also possible that when people are depressed they may not have the energy to take medicines regularly and they may have problems remembering when to take them. Much work lies ahead to clarify these issues and provide guidance for clinicians caring for younger people with depression and HIV.

A recent study from Paris, France, conducted between 2017 and 2021 found that people with HIV had an elevated risk of stroke. People under the age of 55 were more likely to have a detectable viral load, likely contributing to elevated inflammation and stroke risk.

—Sean R. Hosein

REFERENCES:

  1. Ma J, Nance RM, Tirschwell D, et al. Associations Between Depressive Symptom Severity and Incident Stroke among people with HIV. Conference on Retroviruses and Opportunistic Infections, March 3-6, 2024. Abstract 110.
  2. Stammler R, Guillaume J, Mazighi M, et al. First-ever acute ischemic strokes in HIV-infected persons: A case-control study from stroke units. Annals of Clinical and Translational Neurology. 2024; in press.