Uncontrolled HIV and inflammation is associated with intracranial saccular aneurysm presence

Abstract

Objective:To study biomarkers of inflammation in cerebrovascular disease, exploring modifiable and non-modifiable biochemical and clinical risk factors associated with the presence of intracranial saccular aneurysms (ISAs) in an HIV-positive cohort.Design:A cross-sectional community-based study was used to study blood biomarkers of inflammation as predictors of cerebrovascular disease, specifically the presence of ISAs in persons with HIV. Potential biochemical and clinical predictors of ISA presence were identified.Methods:Time of flight magnetic resonance angiography and magnetic resonance imaging data identified the presence of ISAs in an HIV-positive cohort. Quantitative assays for neuroinflammatory biomarkers were performed on plasma blood samples. Lasso regression models were used to identify neuroinflammatory biomarkers and clinical risk factors associated with ISAs.Results:Eight of 72 participants had radiographically identified ISAs. ISAs were more common in non-Hispanic black participants (18.5% vs. 0% presence in nonblack patients). Participants with well controlled HIV (defined as CD4+ count >200 cells/ml and undetectable viral load at time of magnetic resonance imaging) had lower odds of ISAs (odds ratio: 0.19, 95% confidence interval 0.05–0.79) independent of age, sex, ethnicity and vascular risk factors. Macrophage inflammatory protein-1 p, an HIV- suppressive factor detected in participant blood samples, was inversely associated with aneurysm presence.Conclusion:Well controlled HIV is associated with fewer ISAs. The identification of non-modifiable and modifiable risk factors contributing to ISA formation may provide valuable insight to impact clinical practice and inform the pathophysiology underlying ISA formation.

Contrasting Cases of HIV Vasculopathy Associated Fusiform Aneurysms

“…A recent cross-sectional study reported a correlation between the presence of several cytokines and incidence of intracranial saccular aneurysms in uncontrolled HIV patients. 11 Further, prior studies have reported the presence of leukocytoclastic vasculitis in extracranial aneurysms in HIV patients. 12 Future research is needed to examine these potential pathophysiologic mechanisms, including pathologic exam of intracranial aneurysms.…”

Comfort nursing theory on the postoperative rehabilitation quality and nursing satisfaction of patients with intracranial aneurysm

“…Comfort nursing from the perspective of high-quality nursing is a holistic, individualized, creative and effective nursing model. [5][6][7] This study compared the effects of comfort nursing and routine nursing on the postoperative rehabilitation progress of patients with intracranial aneurysms from the perspective of high-quality nursing, and discussed the nursing effect of comfort nursing on patients with intracranial aneurysms from the perspective of high-quality nursing.…”