Stroke and HIV infection are both common medical problems in the day to day clinical
practice. Although data from developed countries confirm HIV infection as a risk for stroke the exact
underlying mechanism is still unclear. Little data exist on the magnitude of HIV among patients with
stroke in Tanzania. This cross‐sectional study was carried out to determine the prevalence of HIV and
assess its impact on the clinical presentation and outcome of patients admitted with stroke at the
Muhimbili National Hospital, Dar es Salaam, Tanzania between May and November 2008. Patients
were clinically evaluated through history and physical examination. Presence of HIV was determined
by demonstration of HIV antibodies through an ELISA test. CD4+ T‐lymphocyte count was
determined by flowcytometry. Complete blood counts, as well as lipid profile and blood glucose
levels were also determined. A total of 215 patients with stroke, constituting 6.8% of the admissions,
were analyzed. The prevalence of HIV among patients with stroke was 20.9% (45/215). The overall
mean (±SD) age of patients with stroke who were HIV infected was 47.2 (± 14.5) years, while that
among patients with stroke but HIV un‐infected was 56.1 (±15.1) years (P< 0.001). The proportion of
patients with stroke and HIV who had hypertension was 53.3% (24/45), whereas among those HIV
uninfected was 80.6% (137/170) (P=<0.001). Furthermore, fever, anaemia, diarrhoea, tuberculosis and
Kaposi’s sarcoma were significantly more prevalent among those with HIV than those with no HIV
infection. The respective proportions were 44% vs 24.7%; 26.7% vs 7.6%; 20.0% vs 2.9%; 13.3% vs 1.2%;
and 6.7% vs 0% (P<0.01). Majority (58.3%) of the HIV infected stroke patients had CD4 counts of less
than 200cells/  μl. The mean duration of hospital stay of 10.3 days was significantly longer among
those with HIV compared to that of 7.3 days among the HIV un‐infected patients with stroke
(P=0.001). While on univariate analysis both fever and anaemia were associated with mortality, on
multivariate analysis the presence of fever was found to be significantly associated with mortality
among patients with stroke and HIV. In conclusion, the prevalence of HIV infection among patients
with stroke was high. Patients with stroke and HIV were younger, had significant immunodeficiency
and presented with other HIV‐related illnesses. Early detection of HIV through enhanced counselling
and testing is recommended.