Abstract Details

Title Neuroimaging Findings in HIV-Infected Patients at San Francisco General Hospital, 1997-2012

Topic Infections/AIDS/Prion Disease

Presentation(s) P06 - (-)

Poster/Presentation
Number 181

Objective

Background BACKGROUND: There have been no large reviews of neuroimaging findings in the HIV population in the last decade in the context of more recent practice changes, including earlier initiation of antiretroviral therapy.

Design/Methods DESIGN/METHODS: A retrospective observational study of HIV-infected patients seen at San Francisco General Hospital between 1/1997 and 9/2012 was conducted. Of 5398 patients screened, 490 underwent at least one brain magnetic resonance imaging (MRI) scan. Contrast was administered in 75% of scans. Predictor variables included in cross-sectional analysis were: indication for MRI, CD4 count, and use of antiretroviral therapy (ART).

Results RESULTS: Of 305 brain MRIs reviewed in detail, 263 (86.3%) had some identified abnormality. The most common findings were periventricular and/or subcortical white matter changes of varying degrees (n=126), followed by global volume loss (n=83). Opportunistic infections or neoplasms were identified in 6.5% (n=17). These included progressive multifocal leukoencephalopathy, toxoplasmosis, lymphoma, and CMV ventriculitis, and were seen in patients with lower CD4 counts and without ART use. Hydrocephalus was reported in 12 cases. Other findings included stroke, traumatic sequelae, basal ganglia abnormalities, meningiomas, and developmental venous anomalies. Altered mental status, cognitive decline, trauma, headache, and sepsis were common reasons for obtaining imaging.

Conclusions CONCLUSIONS: While opportunistic infections were uncommonly seen compared to earlier in epidemic, other MRI abnormalities were more frequent, including white matter changes, in the current era of anti-retroviral therapy.

Authors/Disclosures
Marie F. Grill, MD (Mayo Clinic) PRESENTER	Dr. Grill has nothing to disclose.
Nancy Edwards, MD	No disclosure on file
Richard W. Price, MD, FAAN (San Francisco General Hospital)	No disclosure on file
	No disclosure on file

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