ORIGINAL RESEARCH article
Front. Stroke
Sec. Mechanisms, Models, and Biomarkers of Stroke
This article is part of the Research TopicStroke Realities in Africa: Challenges and SolutionsView all 9 articles
Plasma Apolipoprotein E and Monocyte Chemoattractant Protein-1 Levels in Young People with HIV and Ischemic Stroke in Lusaka, Zambia
Provisionally accepted
Stanley Zimba1*
Owen Ngalamika1
Emmanuel Mukambo2Mike Chisha2
Violet Kayamba1Lloyd Mulenga2Omar Siddiqi3Deanna Saylor4
Owen A Ross5
Masharip Atadzhanov1- 1School of Medicine, University of Zambia, Lusaka, Zambia
- 2University Teaching Hospital, Lusaka, Zambia
- 3Harvard Pilgrim Health Care, Harvard Medical School, Boston, Massachusetts, United States
- 4University of North Carolina Hospitals, Chapel Hill, North Carolina, United States
- 5Mayo Clinic Florida, Jacksonville, Florida, United States
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Apolipoprotein E (ApoE) and Monocyte Chemoattractant Protein-1 (MCP-1) are inflammatory markers associated with premature atherosclerosis, leading to increased cardiovascular disease risk among people with HIV (PWH). We aimed to evaluate the association between plasma levels of these inflammatory markers and ischemic stroke in young PWH.We conducted a prospective case-control study at the University Teaching Hospital in Lusaka, Zambia between March 2022 and October 2024, comparing young PWH with noncardioembolic ischemic stroke (cases) to age-and sex-matched PWH without a history of stroke (controls). Standardized data collection instruments were used to collect information on other known risk factors for stroke including demographic, clinical, laboratory, and imaging parameters. ELISA was done to measure ApoE and MCP-1 levels in plasma of both cases and controls.We analyzed results for 50 cases and 50 controls. Compared to controls, cases were more likely to have (1) traditional stroke risk factors such as hypertension (42% vs. 2%, p=0.001);(2) more poorly controlled HIV, including lower CD4 counts [259 (165-520) cells/µl vs. 452 (380-553) cells/µl, p=0.030)] and higher viral loads [0 (0-4217) copies/ml vs. 0 (0-1578) copies/ml, p=0.007]; (3) markers of atherosclerotic disease, including increased pulse wave velocity (PWV) [
Keywords: Apolipoprotein E, Monocyte chemoattractant protein 1, sub-Saharan Africa, Young onset stroke, HIV infection
Received: 18 Mar 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Zimba, Ngalamika, Mukambo, Chisha, Kayamba, Mulenga, Siddiqi, Saylor, Ross and Atadzhanov. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Stanley Zimba, stanpaulzimba@yahoo.co.uk
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