CT scan findings in HIV-infected patients with space occupying infective lesions

What is it about?

HIV infection with its complications place a huge burden on countries globally. This is increasingly important in developing world countries with their inherent resource-limitations. Access to CT scanning is an essential if we are to diagnose and treat these HIV-related complications appropriately. This study provides an audit of CT scans of HIV-infected patients with space occupying infective lesions and can serve as a baseline for future prospective studies.

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Why is it important?

Most patients were in the third to fourth decade of life with mean CD4 of 125 cells/mm3. A differential comprising toxoplasmosis or tuberculoma [80.9%] was the leading aetiology described. Most frequent clinical features in these patients included seizures [41.8%], confusion or altered mental state [38.2%], headaches [33.6%], hemiparesis [48.2%], and cranial nerve abnormality [22.7%]. The most common CNS sites involved were, in order of decreasing prevalence was parietal, basal ganglia, frontal cortex (31.8% vs. 31.8% vs. 26.4%, respectively). Early initiation of co-trimoxazole and anti-tuberculosis treatment yielded better outcomes compared to the group who received delayed or no treatment with p-values (Pearson’s x2) of 0.0002 and < 0.0001 respectively.

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