Computed tomographic findings of the brain in adult HIV-infected patients at Doctor George Mukhari Academic Hospital, Ga-Rankuwa, Pretoria, South Africa

Abstract

Background/Aim: The aim of this study is to determine the pattern of computed tomographic (CT) findings in HIV-infected patients referred for CT brain at Doctor George Mukhari Academic Hospital (DGMAH) and to correlate the CD4 counts with CT brain findings of the patients on antiretroviral (ARV) drugs, and those that are ARV naïve. Methods: A descriptive, retrospective review of CT brains obtained from 128 slices Philips and GE, CT scanners, medical records, and laboratory results of 364 adult HIV-infected patients over a 6-month period (October 1, 2016–March 31, 2017) was conducted at Radiology Department of DGMAH. Statistical analyses were made using a Statistical Program for Social Sciences software (SPSS version 19.0). Results: From the 364 CT brain findings of HIV-infected patients reviewed, 46.2% were male and 53.8% were female. The findings were as follows: brain atrophy (168; 46.2%); infarcts (55; 15.1%); hydrocephalus (24; 6.6%); white matter disease (18; 4.9%); mass lesions (13; 3.6%); rim enhancing lesions (12; 3.3%); intracranial bleed (11; 3.0%); tuberculous granuloma (32; 8.8%); tuberculous meningitis (15; 4.1%); and cryptococcal meningitis (2; 0.5%). Opportunistic infections and mass lesions still predominate at CD4 count <200 cells/mm3 although the reduction in the prevalence of opportunistic infections was observed. Brain infarct was seen at CD4 count <200 cells/mm3, and brain atrophy was seen at all CD4 count levels (median= 84 cells/mm3). Conclusion: This study was conducted in the post-highly active ARV therapy era, and the most common CT scan brain finding was brain atrophy, followed by brain infarct.