title: [Incidence of strokes in HIV-positive patients treated with long term antiretroviral treatment].
abstract: BACKGROUND
  With the introduction of triple therapy regimen in 1996, the morbidity and mortality associated with HIV infection decreased significantly. Concomitantly with this clinical success, several metabolic changes including diabetes, arterial hypertension, dyslipidemia and lipodystrophy were observed, being associated with the risk of stroke. This study aims to determine the incidence of strokes in HIV-positive patients treated with long term antiretroviral treatment.
  
  
  METHODS
  This was a retrospective cohort study of HIV-positive adult patients receiving long term antiretroviral treatment for at least 12 months. It was conducted at the Approved Treatment Centres of Douala General Hospital (HGD); data collection spanned a 10-year period from May 2001 to April 2010. Patients were treated according to Cameroon national treatment guidelines. The Kaplan-Meyer method was used to determine the time of stroke onset. The Khi-2 test was used to investigate the association between two qualitative variables. The statistical significance level was set at 0.05.
  
  
  RESULTS
  407 patients were included in the study, 62.4% were female, the average age was 40.1 ± 9.9 years. The incidence of strokes was 1.7% over 72 months follow up with no significant difference between women and men (P = 0.76). The incidence rate was calculated to be 0.3 per 100 person years. 85.7% of cases had an ischemic stroke. The mean time from stroke onset was 33.4 months. Factors associated with stroke occurrence were: patients who underwent treatment at WHO Clinical Stage III and IV and with CD4 count> 100/mm3at the start of antiretroviral therapy.
  
  
  CONCLUSIONS
  The incidence of stroke in HIV-positive patients treated with long term antiretroviral therapy is similar to that previously reported but these strokes occur at an early age and justify increased clinical monitoring. A prospective study involving a control population is needed.
authors.affiliation: Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Hôpital Général de Douala, Cameroun.
authors.forename: Yacouba Njankouo
authors.initials: YN
authors.lastname: Mapoure
authors.affiliation: Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Hôpital Général de Douala, Cameroun.
authors.forename: Ines Nepetsoun
authors.initials: IN
authors.lastname: Nkongni
authors.affiliation: Service d'Hépato-gastro-entérologie, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé 1, Cameroun.
authors.forename: Henry Namme
authors.initials: HN
authors.lastname: Luma
authors.affiliation: Service de Pneumologie, Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Hôpital Général de Douala, Cameroun.
authors.forename: Bertrand Hugo Mbtachou
authors.initials: BH
authors.lastname: Ngahane
authors.affiliation: Service de Pédiatrie, Centre de Traitement Agréé de l'Hôpital Général de Douala, Cameroun.
authors.forename: Esther
authors.initials: E
authors.lastname: Barla
authors.affiliation: Service de Dermatologie, Hôpital Général de Douala, Cameroun.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ngwane
authors.affiliation: Département des Sciences Cliniques, Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Cameroun.
authors.forename: Albert Soné
authors.initials: AS
authors.lastname: Mouelle
authors.affiliation: Département de Neurologie, Hôpital Central de Yaoundé, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé 1, Cameroun.
authors.forename: Alfred Kongnyu
authors.initials: AK
authors.lastname: Njamnshi
mesh_terms: D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D018791:CD4 Lymphocyte Count; D002163:Cameroon / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology*; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents
keywords: Cameroon; HIV infection; Strokes; antiretroviral triple therapy regimen