Antiretroviral therapy and risk of stroke

Stroke, also known as cerebral infarction, occurs when not enough blood reaches the brain. The risk of stroke is thought to be increased with AIDS. According to a US study published in 1996, patients with AIDS had an annual incidence of stroke of 1.3% compared to a rate of 0.025% in the general population.1 There is emerging evidence that PI-based treatments may add to this increased risk of stroke among people with HIV.

In HIV-positive people in one study carried out in Italy, protease inhibitors were strongly associated with development of lesions in the carotid vessels (the arteries which connect the heart and the brain). These lesions may lead to stroke. Of the PI-treated patients 29/55 (57.7%) developed carotid lesions compared to 7/47 (15%) of HIV-infected people who had not taken PIs and 6.7% of a local control group. While PI therapy was most strongly associated with the lesions, smoking and degree of immune deficiency were also associated with increased risk of lesions.2


  1. Pinto AN et al. AIDS and cerebrovascular disease. Stroke 27(3): 538-543, 1996
  2. Maggi P et al. Premature lesions of the carotid vessels in HIV-1-infected patients treated with protease inhibitors. AIDS 14(16): F123-128, 2000
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.