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Abstract
Objective: To compare rates of intracerebral hemorrhage (ICH) in HIV-infected and uninfected individuals in a large clinical care cohort and to assess risk factors associated with ICH.
Methods: We identified incident ICH in HIV-infected and uninfected control cohorts from the Partners Health Care system using ICD-9-CM codes. We constructed Cox proportional hazards models to estimate adjusted hazard ratios for HIV infection and other predictors of ICH.
Results: The incidence rate of ICH was 2.29 per 1,000 person-years in HIV-infected individuals compared with 1.23 per 1,000 person-years in uninfected individuals, with an unadjusted incidence rate ratio of 1.85 (95% confidence interval 1.37–2.47, p < 0.001). In a multivariable model, HIV infection was independently associated with a higher hazard of ICH, although its effect diminished with increasing age. Female sex was associated with a lower hazard of ICH in the uninfected cohort but not in the HIV cohort. CD4 count <200 × 106 cells/L and anticoagulant use were predictive of ICH.
Conclusions: HIV infection conferred an increased adjusted hazard of ICH, which was more pronounced in young patients and in women.
GLOSSARY
- ART=
- antiretroviral therapy;
- CKD=
- chronic kidney disease;
- HR=
- hazard ratio;
- ICD-9-CM=
- International Classification of Diseases, Ninth Revision, Clinical Modification;
- ICH=
- intracerebral hemorrhage;
- IRR=
- incidence rate ratio;
- PY=
- person-years;
- RPDR=
- Research Patient Data Registry;
- SAH=
- subarachnoid hemorrhage
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 1690
Supplemental data at Neurology.org
- Received February 18, 2014.
- Accepted in final form June 23, 2014.
- © 2014 American Academy of Neurology
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