Prevalence of HIV infection among stroke patients in Douala

Abstract

To determine the prevalence of HIV infection among stroke patients admitted to the Douala General Hospital (DGH) and to describe the clinical characteristics and outcome of the stroke patients with HIV infection. This prospective cohort study took place in 2010-2015 at the DGH. The study included patients older than 15 years with a CT-confirmed stroke. All patients underwent HIV tests with Western-Blot confirmation. The functional prognosis of the patients was assessed by the Rankin score at 6 months after stroke onset. The prevalence rate of HIV among stroke patients was 6.6% (40/608). Of the 40 HIV-positive patients, 58% were aware of their status at admission; 83% of these patients were receiving antiretroviral therapy. Males were predominant (65%), and the mean age was 51.3 ± 10.4 years. Hypertension was the main cerebrovascular risk factor (65%). At admission, 47.5% of HIV+ patients were febrile, and 7.5% presented with coma. Ischemic stroke accounted for 60% of cases. The mean CD4 cell count was 351 ± 236/mm3 with a median of 330/mm3. The length of stay was 10 ± 8 days. At 6 months, the cumulative mortality of HIV+ patients was 37.5%, and 38.5% were dependent (Rankin>2). HIV prevalence is high among stroke patients in our setting. This suggests that an HIV test should be routinely proposed to stroke patients.

Keywords: Cameroon; HIV infection; prevalence; stroke.