The Imaging Findings of the Brain Lesions in Adult HIV Patients at Ramathibodi Hospital
Background: The central nervous system (CNS) is major targets of HIV. Imaging plays major role for diagnosis. In the era of highly active antiretroviral therapy (HAART), immune reconstitution inflammatory syndrome (IRIS) frequently develops, causing worsening of opportunistic infection after initial...
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| Main Authors: | , , , , , , , |
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| Other Authors: | |
| Format: | Original Article |
| Language: | English |
| Published: |
2022
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| Subjects: | |
| Online Access: | https://repository.li.mahidol.ac.th/handle/123456789/79503 |
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| Institution: | Mahidol University |
| Language: | English |
| Summary: | Background: The central nervous system (CNS) is major targets of HIV. Imaging plays major role for diagnosis. In the era of highly active antiretroviral therapy (HAART), immune reconstitution inflammatory syndrome (IRIS) frequently develops, causing worsening of opportunistic infection after initial of HAART and atypical imaging findings.
Objective: To evaluate radiographic findings of HIV-related brain lesions and imaging characteristics in CNS-IRIS at Ramathibodi Hospital.
Methods: Adult HIV patients who performed the first CT of the brain and first MRI of the brain were reviewed. The final diagnoses from medical records were assessed followed by CSF analysis, pathological report, and therapeutic treatment.
Results: Eighty-one HIV patients (64 CT brains and 44 MRI brains) with HIV-related brain lesions were diagnosed. There were 24.7% cryptococcal infection, 18.5% tuberculous infection, 8.6% HIV encephalopathy and progressive multifocal leukoencephalopathy (PML), 7.4% neurosyphilis, 6.2% toxoplasmosis and TB-IRIS, 2.5% primary CNS lymphoma, and others.
Conclusions: Cryptococcal infection was the most common disease of adult HIV-related brain lesions followed by tuberculous infection, HIV encephalopathy, and PML. Besides less basal meningitis and hydrocephalus in tuberculous meningitis and no demonstrated target lesion in tuberculoma compared with prior literatures, other imaging findings of each HIV-related brain lesions were not different from those of the prior studies. |
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