Published Online
on December 2, 2002

A more recent version of this article appeared on January 1, 2003

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Submitted on July 1, 2002
Accepted on July 26, 2002

Stroke in Black South African HIV-Positive Patients. A Prospective Analysis

Andre Mochan FCP(SA); Mala Modi FCRad(SA), MMed(Wits); and Girish Modi PhD(Lond), FCP(SA), FRCP(Lond)^*

From the Division of Neurology, Department of Neurosciences (A.M., G.M.), and Division of Radiology, Department of Radiation Sciences in the School of Clinical Medicine (M.M.), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

^* To whom correspondence should be addressed. E-mail: gmodicns{at}mweb.co.za.

Background and Purpose—Stroke associated with HIV infection is poorly characterized. In this study we analyze the association in a black African population.

Methods—The clinical, laboratory, and radiological characteristics of 35 hospital-based black South African, heterosexual, HIV-infected patients who did not abuse intravenous drugs and presented with strokes were prospectively studied. The patients were antiretroviral therapy naive. Patients with other intracranial space-occupying lesions were excluded from the study.

Results—The age range was 20 to 61 years (mean, 32.1 years). There were 21 female and 14 male patients, with a female to male ratio of 1.5:1. Cerebral infarction occurred in 33 patients (94%) and intracerebral hemorrhage in 2 patients (6%). Underlying causes were identified in 30 of the 35 patients (86%) and included coagulopathies, meningitis, cardioembolism, and hypertension. The most common coagulopathy was protein S deficiency. No cause was found in 5 patients (14%).

Conclusions—The results are similar to data from studies on young black African stroke patients who are HIV negative.

Key words: blood coagulation disorders • HIV • stroke

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