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dc.contributor.authorAlvaro-Meca, Alejandro
dc.contributor.authorBerenguer, Juan
dc.contributor.authorDiaz Franco, Asuncion 
dc.contributor.authorMicheloud, Dariela
dc.contributor.authorAldámiz-Echevarria, Teresa
dc.contributor.authorFanciulli, Chiara
dc.contributor.authorResino, Salvador
dc.identifier.citationPLoS One. 2017 Jun 15;12(6):e0179493.es_ES
dc.description.abstractThe incidence of stroke in human immunodeficiency virus (HIV)-infected individuals has been well analyzed in recent epidemiological studies. However, little is known about the specific contribution of hepatitis C virus (HCV) infection to stroke among HIV-infected individuals. The aims of this study were to analyze trends in the incidence rates of stroke in HIV-infected individuals during the combination antiretroviral (cART) era in Spain and to categorize them by the presence or absence of HCV coinfection. We analyzed hospital discharges with a diagnosis of stroke in Spain according to ICD-9-CM during 1997-2013. The study period was divided into four calendar periods (1997-1999, 2000-2003, 2004-2007, and 2008-2013). Patients were classified according to HCV serology. The number of HIV-infected patients was estimated based on data from the National Centre of Epidemiology. We calculated incidence rates (events per 10,000 patient-years) and in-hospital case fatality rates (CFR). The incidence of hemorrhagic stroke (HS) decreased in HIV-monoinfected patients (15.8 [1997-1999] to 6.5 [2008-2013]; P<0.001) and increased in HIV/HCV-coinfected patients (1.3 [1997-1999] to 5.5 [2008-2013]; P<0.001). The incidence of ischemic stroke (IS) decreased in HIV-monoinfected patients (27.4 [1997-1999] to 21.7 [2008-2013]; P = 0.005) and increased in HIV/HCV-coinfected patients (1.8 [1997-1999] to 11.9 [2008-2013]; P<0.001). The CFR was 3.3 times higher for HS than for IS for the whole study period. The CFR of HS in HIV-monoinfected patients decreased significantly (47.4% [1997-1999] to 30.6% [2008-2013]; P = 0.010) but did not change significantly among HIV/HCV-coinfected patients (41.4% [1997-1999] to 44.7% [2008-2013]; P = 0.784). The CFR of IS in the whole HIV-infected population decreased significantly (14.6% [1997-1999] to 10.9% [2008-2013]; P = 0.034), although no significant differences were found when each group was analyzed separately. In conclusion, after the introduction of cART, HS and IS rates decreased in HIV-monoinfected individuals, but increased steadily in HIV/HCV-coinfected individuals.es_ES
dc.description.sponsorshipThis work was supported by grants from “Instituto de Salud Carlos III” (grant numbers PI14/01094, and PI14CIII/00011) and Red Española de Investigación en SIDA (RIS, AIDS Research Network; grant numbers RD16/0025/0017, and RD16CIII/0002/0002). This study was (partially) funded by the RD16/0025 project as part of the Plan Nacional R + D + I and cofunded by ISCIII- Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER). JB is an investigator of the Programa de Intensificación de la Actividad Investigadora en el Sistema Nacional de Salud (I3SNS) (Ref. INT15/00079).es_ES
dc.publisherPublic Library of Science (PLOS) es_ES
dc.subject.meshAdult es_ES
dc.subject.meshAged es_ES
dc.subject.meshAnti-Retroviral Agents es_ES
dc.subject.meshBrain Ischemia es_ES
dc.subject.meshFemale es_ES
dc.subject.meshHumans es_ES
dc.subject.meshIncidence es_ES
dc.subject.meshIntracranial Hemorrhages es_ES
dc.subject.meshMale es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshRetrospective Studies es_ES
dc.subject.meshSpain es_ES
dc.subject.meshStroke es_ES
dc.subject.meshCoinfection es_ES
dc.subject.meshHIV Infections es_ES
dc.subject.meshHIV-1 es_ES
dc.subject.meshHepacivirus es_ES
dc.subject.meshHepatitis C es_ES
dc.titleStroke in HIV-infected individuals with and without HCV coinfection in Spain in the combination antiretroviral therapy eraes_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderUnión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) 
dc.contributor.funderInstituto de Salud Carlos III 
dc.contributor.funderRed de Investigación Cooperativa en Investigación en Sida (España) 
dc.identifier.journalPloS onees_ES
dc.repisalud.centroISCIII::Centro Nacional de Microbiologíaes_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemologíaes_ES
dc.rights.accessRightsopen accesses_ES

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