Evidence map›Paper›PMID 41023732›Full record

ArticleAIDS research and therapy2025

The association of antiretroviral therapy type and duration of use with stroke in people living with HIV in Zambia.

Stanley Zimba, Owen Ngalamika, Emmanuel Mukambo, Theresa Shankanga, Taonga Msimuko, Diwell Mwansa, Bwalya Mulenga, Mike Chisha, Mashina Chomba, Melody Asukile and 7 more

Abstract read
In one paragraph

Article in AIDS research and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Stanley ZimbaDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia. stanpaulzimba@yahoo.co.uk.
Owen NgalamikaDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
Emmanuel MukamboDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Theresa ShankangaDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Taonga MsimukoDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Diwell MwansaDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Bwalya MulengaDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Mike ChishaDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Mashina ChombaDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
Melody AsukileDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Lorraine ChishimbaDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Violet KayambaDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
Lloyd MulengaDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Omar SiddiqiDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
Owen A RossDepartment of Neuroscience, Mayo Clinic College of Medicine, Jacksonville, FL, USA.
Masharip AtadzhanovDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.
Deanna SaylorDepartment of Internal Medicine, University Teaching Hospital, P/Bag RW IX, Lusaka, Zambia.

Funding

Partnership for Global Health Research Training Program (Renewal)-Supplement for OBSSR, NCI, NCI-AIDS and NIDCDD43TW010543 · FIC · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Wafaie W Fawzi, DAVIDSON HOWES HAMER · 2017 to 2026
$12.1M
UNZA-Vanderbilt Training Partnership for HIV-NCD Research (UVP-2)D43TW009744 · FIC · VANDERBILT UNIVERSITY MEDICAL CENTER · PI HEIMBURGER, DOUGLAS CORBETT, MUTALE, WILBROAD · 2015 to 2025
$3.2M
Adaptation and Implementation of Clinical Practice Guidelines to Improve Stroke Outcomes in ZambiaK01TW011771 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SAYLOR, DEANNA RAE · 2021 to 2025
$1.1M
FIC NIH HHS D43 TW009744FIC NIH HHS D43 TW010543FIC NIH HHS K01 TW011771Fogarty International Centre of the US National Institutes of Health 2D43TW009744NIH Office of AIDS Research NIH K01 TW011771-01
6 · The paper itself

Abstract

backgroundPeople living with HIV (PLWH) are at increased risk of stroke due to many factors including possibly antiretroviral therapy (ART) use. We sought to evaluate the association between ART type and duration of use with stroke in PLWH.

methodsWe conducted a prospective exploratory case-control study at the University Teaching Hospital in Lusaka, Zambia between March 2022 and October 2024 in adult (≥ 18 years) PLWH comparing those with stroke (cases) and without (controls) matched (1:2) for age, sex and race. Standardized data collection instruments were used to collect clinical, laboratory and imaging information. This information was compared between the cases and controls using Chi-square, t-tests, Mann-Whitney U-test (not normally distributed) and multivariable conditional logistic regression analyses with subgroup analysis by ART duration done for the cases.

resultsWe analyzed results for 205 cases and 410 controls. Compared to controls, cases were more likely to have hypertension (71% vs. 18%, p = 0.001), lower CD4 counts [293(163-592) cells/µl vs. 533 (376-688) cells/µl, p = 0.0001] and to be on second line ART (23% vs. 4%, p = 0.001). Hypertension (aOR 19.7, 95% CI 3.1-126.4, p = 0.002) and Tenofovir Disoproxil Fumarate (TDF) use (aOR 85.3, 95% CI 5.3-1380.7, p = 0.002) were associated with increased odds of stroke, whereas Dolutegravir (aOR 0.03, 95% CI 0.001-0.58, p = 0.02) and alcohol use (aOR 0.24, 95% CI 0.06-0.95) were associated with reduced odds of stroke. The majority of stroke patients on long-term ART were using Dolutegravir (80% vs. 35%, p = 0.001) and TDF (72% vs. 42%, p = 0.01).

conclusionIn PLWH, TDF associates with higher odds of stroke. Although Dolutegravir associates with reduced odds of stroke, stroke patients on long-term ART are more likely to be on it.

Indexed as

Anti-HIV AgentsAnti-Retroviral AgentsHIV InfectionsStrokeAdultCase-Control StudiesCD4 Lymphocyte CountDolutegravirFemaleHeterocyclic Compounds, 3-RingHumansMaleMiddle AgedOxazinesPiperazinesProspective StudiesAnti-HIV AgentsAnti-Retroviral AgentsDolutegravirHeterocyclic Compounds, 3-RingOxazinesPiperazinesPyridonesTenofovirAntiretroviral therapyHIV infectionStrokeSub-Saharan AfricaZambia

Identifiers

PMID41023732
PMCPMC12482629

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.