For the treatment of VZV vasculitis, the role of ste- roids as adjunctive therapy to acyclovir is not well established. Chronic inflammation is often found in people liv- ing with well-controlled HIV infection. It is uncer- tain whether, in addition to comprehensive vascular risk factor control, there may be a role for additional immunomodulation in this population. 5.14. Other Genetic Disorders Recommendations for Other Genetic Disorders Referenced studies that support recommendations are summarized in online Data Supplements 51 and 52. COR LOE Recommendations In patients with ischemic stroke or TIA and cystathionine -synthase deficiency, pyridoxine (in responsive patients) and a low-methionine, cysteine-enhanced diet supplemented with pyridoxine, vitamin B12 , and folate are recommended to reduce plasma homocysteine to population normal levels and thereby reduce the risk of recurrent In patients with ischemic stroke or TIA and Anderson-Fabry disease, agalsidase alfa or agalsidase beta is of uncertain value in preventing recurrent stroke or Synopsis Beyond SCD, other rare diseases cause stroke or stroke-like syndromes for which there are specific therapies. Recently, there have been randomized tri- als of enzyme replacement therapy in Anderson-Fabry disease, but such methodology is rare. Even in Ander- son-Fabry disease, it has been difficult to adequately power studies to assess efficacy for stroke preven- Although in 1 German population the preva- lence of Fabry disease in young men with first-time cryptogenic ischemic stroke was reported to be as high as 2.17%,743 it appears that, for most popula- tions of young men with first-time cryptogenic stroke, the rate is <1%.744 The prevalence rate appears to be higher in young patients with recurrent cryptogenic ischemic stroke relative to young patients with first- time cryptogenic stroke.743 CLINICAL STATEMENTS AND GUIDELINES Kleindorfer Recommendation-Specific Supportive Text 1. 