HIV infection, and potentially its treatment, increases the risk of an arterial ischemic stroke. Multiple etiologies and lack of clear case definitions inhibit progress in this field. Several etiologies, many treatable, are relevant to HIV-related stroke. To fully understand the mechanisms and the terminology used, a robust classification algorithm to help ascribe the various etiologies is needed. This consensus paper considers the strengths and limitations of current case definitions in the context of HIV infection. The case definitions for the major etiologies in HIV-related strokes were refined (e.g., varicella zoster vasculopathy and antiphospholipid syndrome) and in some instances new case definitions were described (e.g., HIV-associated vasculopathy). These case definitions provided a framework for an algorithm to help assign a final diagnosis, and help classify the subtypes of HIV etiology in ischemic stroke.
Bibliographical noteFunding Information:
L.A. Benjamin reports no disclosures. A. Bryer served on the scientific advisory board for the Population Health Research Institute and Bayer Pharmaceuticals, received travel funding from the Population Health Research Institute, Bayer Pharmaceuticals, and Boehringer Ingelheim, is on the editorial board for International Journal of Stroke, and consulted for Boehringer Ingelheim. S. Lucas and A. Stanley report no disclosures. T.J. Allain consulted for MRC (UK) and Dignitas International. E. Joekes reports no disclosures. H. Emsley received speaker honoraria from Medileaf Ltd., is on the editorial board for The Neurohospitalist, and received research support from Sydney Driscoll Neuroscience Foundation. I. Turnbull, C. Downey, C.-H. Toh, K. Brown, and C. Smith report no disclosures. D. Brown received research support from the UK Department of Health. C. Ison is an associate editor for Sexually Transmitted Infections and is editor for Journal of Microbiology. E.L. Corbett reports no disclosures. A. Nath is an associate editor for Journal of Neurovirology, holds a patent for Tat as an immunogen, Disogenin for Treatment of Neurodegenerative Diseases, Role of Kv Channels in Neuroregeneration and Protection, Role of Lominoid Compounds as neuroprotective agents, Tat ELISA, and received research support from the NIH. R.S. Heyderman reports no disclosures. M.D. Con-nor received travel funding and speaker honoraria from AbbVie, is an associate editor for Practical Neurology, and has provided expert and witness reports to noncommercial entities. T. Solomon is on the scientific advisory board for Study of Ebola Vaccine ChAd3-EBO-z. Go to Neurology.org/nn for full disclosure forms.
L.B. was supported by the Wellcome Trust. T.S. was supported by the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections at Liverpool.
© 2016 American Academy of Neurology