Conclusion
Some evidence shows that HIV-1 itself changes the predilection for stroke, whose causes are also related to the immunosuppression, to the risk behaviors for HIV-1 infection, and to the metabolic effects of combined therapies, especially those with PIs.
In Western countries, the survival of patients infected with a neuro- and possibly vasculotrophic virus has increased considerably. Moreover, with the aging of this population, the frequency of cerebrovascular diseases in the context of immunodepression and chronic viral infection may only increase in the near future. HIV-1-infected patients presenting with a suspicion of stroke must undergo an exhaustive work-up, because therapeutic decisions in that particular situation should be rapidly individualized. If HIV-1 can indeed participate in the pathogenetic role of cerebrovascular diseases, the good blood-brain barrier penetration of new antiretroviral therapies could be a suitable therapeutic approach for this process.References
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