The Changing Epidemiology of Stroke in Acquired Immune Deficiency Syndrome (AIDS). (P1.089)

Objective:to analyze trends in the incidence of stroke with AIDS, demographics and AIDS related conditions over the last decade. Background:Patients with AIDS develop ischemic stroke through distinct mechanisms. These include infections(syphilis, tuberculosis, varicella), cocaine abuse, endocarditis and hypercoagulability. The effect of improved awareness, increased detection and treatment with highly active antiretroviral therapy(HAART) on the incidence and demographics of AIDS patients with stroke is unknown. Methods:Data from the Nationwide Inpatient Sample(NIS) from 2001-2010 were analyzed. Patients with diagnoses of ischemic stroke and AIDS were identified using ICD-9codes. Certain AIDS associated conditions were also evaluated. Demographics, survival and frequency of AIDS associated conditions were analyzed for trends over time. Results:Proportion of AIDS among incident stroke patients increased significantly in the first half of the decade but leveled off in the latter half. Median age of all strokes decreased from 76y in 2001 to 72y in 2010. Conversely, the median age for men and women with stroke and AIDS increased from 44y to 51y and from 39y to 50y respectively. Proportion of stroke patients >60y decreased significantly across the decade from 83.8[percnt] to 76.6[percnt]. Proportion of men with stroke and AIDS >60y increased from 8.9[percnt] to 21.7[percnt], and women with stroke and AIDS >60y increased from 2.1[percnt] to 13.2[percnt]. Death rates from stroke in the AIDS patient declined, consistent with the improved survival in the general stroke population. Stroke patients with AIDS had increased odds of syphilis, varicella, tuberculosis, endocarditis, cocaine abuse and hypercoagulability, but the trends in incidence of these conditions were unchanged. Conclusions:There is an increased frequency of AIDS among stroke patients, possibly due to the increased detection of AIDS. In the HAART era, the median age of incident stroke in AIDS has increased. Whether HAART can reduce the incidence and improve survival of stroke needs to be explored. Disclosure: Dr. Kucab has received personal compensation for activities with Bayer HealthCare as an advisory board participant. Dr. Bhattacharya has nothing to disclose.