{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:16:40Z","timestamp":1791357400166,"version":"4.3.1"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Human immunodeficiency virus (HIV) infection has been shown to increase both ischemic and hemorrhagic stroke risks, but there are limited data on the safety and outcomes of intravenous thrombolysis with tPA (tissue-type plasminogen activator) for acute ischemic stroke in HIV-infected patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>A retrospective chart review of intravenous tPA-treated HIV patients who presented with acute stroke symptoms was performed in 7 large inner-city US academic centers (various search years between 2000 and 2017). We collected data on HIV, National Institutes of Health Stroke Scale score, ischemic stroke risk factors, opportunistic infections, intravenous drug abuse, neuroimaging findings, and modified Rankin Scale score at last follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              We identified 33 HIV-infected patients treated with intravenous tPA (mean age, 51 years; 24 men), 10 of whom were stroke mimics. Sixteen of 33 (48%) patients had an HIV viral load less than the limit of detection while 10 of 33 (30%) had a CD4 count &lt;200\/mm\n              <jats:sup>3<\/jats:sup>\n              . The median National Institutes of Health Stroke Scale score at presentation was 9, and mean time from symptom onset to tPA was 144 minutes (median, 159). The median modified Rankin Scale score for the 33-patient cohort was 1 and for the 23-patient actual stroke cohort was 2, measured at a median of 90 days poststroke symptom onset. Two patients had nonfatal hemorrhagic transformation (6%; 95% confidence interval, 1%\u201320%), both in the actual stroke group. Two patients had varicella zoster virus vasculitis of the central nervous system, 1 had meningovascular syphilis, and 7 other patients were actively using intravenous drugs (3 cocaine, 1 heroin, and 3 unspecified), none of whom had hemorrhagic transformation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Most HIV-infected patients treated with intravenous tPA for presumed and actual acute ischemic stroke had no complications, and we observed no fatalities. Stroke mimics were common, and thrombolysis seems safe in this group. We found no data to suggest an increased risk of intravenous tPA-related complications because of concomitant opportunistic infections or intravenous drug abuse.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.117.019570","type":"journal-article","created":{"date-parts":[[2017,12,22]],"date-time":"2017-12-22T19:11:22Z","timestamp":1513969882000},"page":"228-231","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Intravenous Thrombolysis for Stroke and Presumed Stroke in Human Immunodeficiency Virus\u2013Infected Adults"],"prefix":"10.1161","volume":"49","author":[{"given":"Mahmoud A.","family":"AbdelRazek","sequence":"first","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mampre","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Cervantes-Arslanian","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cora","family":"Ormseth","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo","family":"Haussen","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran T.","family":"Thakur","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Lyons","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan R.","family":"Smith","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua Z.","family":"Willey","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farrah J.","family":"Mateen","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (M.A.A., O.O., F.J.M.); Department of Neurology, Columbia University Medical Center, New York, NY (J.G., K.T.T., J.Z.W.); Department of Neurology, Yale-New Haven Hospital, CT (D.M., C.O.); Department of Neurology, Boston University School of Medicine, MA (A.C.-A.); Department of Neurology, University of Miami Hospital, FL (D.H.); Department of Neurology, Brigham and Women\u2019s Hospital\u2013Harvard Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","unstructured":"Number of people living with HIV and HIV prevalence maps. 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Accessed August 10 2017."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000352"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-016-0439-2"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12506"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000437296.97946.73"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2047487312447843"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.1.35"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.09.011"},{"issue":"10","key":"e_1_3_3_10_2","first-page":"1","article-title":"Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13 years\u2013United States, 2008.","volume":"57","author":"Schneider E","year":"2008","unstructured":"Schneider E, Whitmore S, Glynn KM, Dominguez K, Mitsch A, McKenna MT; Centers for Disease Control and Prevention (CDC). Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13 years\u2013United States, 2008. MMWR Recomm Rep. 2008;57(RR-10):1\u201312.","journal-title":"MMWR Recomm Rep"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/003693305700200504"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332401"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181dad5a6"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.08.023"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.117.019570","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:47:36Z","timestamp":1715611656000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.117.019570"}},"subtitle":["A Retrospective, Multicenter US Study"],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1161\/STROKEAHA.117.019570"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.117.019570","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1]]},"assertion":[{"value":"2017-08-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-11-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}