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Home >> Publications >> Association of Cytomegalovirus End-Organ Disease with Stroke in People Living with HIV/AIDS: A Nationwide Population-Based Cohort Study

Publication

Author(s):

Yen YF1,2,3, Jen I3,4, Chen M5,6, Chuang PH3,7,8, Liu YL3, Sharp GB9, Chen YM3,10.

Pub Title:

Association of Cytomegalovirus End-Organ Disease with Stroke in People Living with HIV/AIDS: A Nationwide Population-Based Cohort Study

Pub Date:

Mar 17 2016

Pub Region(s):

Asia-Pacific

Journal:

Title: 
PLoS One

PubMed: 26986005
Pub PDF:

OBJECTIVES: Cytomegalovirus (CMV) infection might increase the risk of cardiovascular event. However, data on the link between incident stroke and co-infections of CMV and human immunodeficiency virus (HIV) are limited and inconsistent. This nationwide population-based cohort study analyzed the association of CMV end-organ disease and stroke among people living with HIV/AIDS (PLWHA).

METHODS: From January 1, 1998, this study identified adult HIV individuals with and without CMV end-organ disease in the Taiwan National Health Insurance Research Database. All patients were observed for incident stroke and were followed until December 31, 2012. Time-dependent analysis was used to evaluate associations of CMV end-organ disease with stroke.

RESULTS: Of the 22,581 PLWHA identified (439 with CMV end-organ disease and 22,142 without CMV end-organ disease), 228 (1.01%) had all-cause stroke during a mean follow-up period of 4.85 years, including 169 (0.75%) with ischemic stroke and 59 (0.26%) with hemorrhagic stroke. After adjusting for age, sex, comorbidities, opportunistic infections after HIV diagnosis, and antiretroviral treatment, CMV end-organ disease was found to be an independent risk factor for incident all-cause stroke (adjusted hazard ratio [AHR], 3.07; 95% confidence interval [CI], 1.70 to 5.55). When stroke type was considered, CMV end-organ disease was significantly positively associated with the risk of ischemic stroke (AHR, 3.14; 95% CI, 1.49 to 6.62) but not hemorrhagic stroke (AHR, 2.52; 95% CI, 0.64 to 9.91).

CONCLUSIONS: This study suggested that CMV end-organ disease was an independent predictor of ischemic stroke among PLWHA.

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Citation:

PLoS One. 2016 Mar 17;11(3):e0151684. doi: 10.1371/journal.pone.0151684. eCollection 2016. Association of Cytomegalovirus End-Organ Disease with Stroke in People Living with HIV/AIDS: A Nationwide Population-Based Cohort Study. Yen YF1,2,3, Jen I3,4, Chen M5,6, Chuang PH3,7,8, Liu YL3, Sharp GB9, Chen YM3,10.