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Original ArticleOpen Access
Computer Tomographic Findings of the Brain in HIV-Patients at Ramathibodi Hospital
Hongsakul K 
,
Laothamatas J
,
Laothamatas J Objective: To determine the underlying cause of the brain lesions in adult HIV patients referred for CT scan at
Ramathibodi Hospital and to evaluate accuracy of CT for the diagnosis of the brain lesion.
Material and Method: Data from first CT scan of the brain of 195 adult HIV patients at Ramathibodi Hospital
were reviewed. The final diagnoses from medical records were assessed followed by CSF analysis, pathological
report, and therapeutic treatment. The accuracy of the CT brain was evaluated using sensitivity, specificity,
positive predictive value (PPV) and negative predictive value (NPV).
Results: One hundred ninety five adult seropositive patients for HIV underwent CT scan of the brain, 59% were
HIV encephalopathy (HIVE), 22% toxoplasmosis, 9% cryptococcoma, 5% tuberculous meningitis, 4% tuberculoma,
3% progressive multifocal leukoencephalopathy (PML), 2% lymphoma, and 1% normal. In nonspecified
causes (from CT scan), 33% were meningitis, 4% cerebritis, and 5% infarction. CT was found to have
high sensitivity, specificity, PPV, and NPV for toxoplasmosis (92%, 96%, 86%, and 98%, respectively).
Conclusion: HIV encephalopathy was the most common finding of adult HIV brains. Toxoplasmosis was the
most common opportunistic parenchymal brain lesion in adult HIV brains. CT was the modality of choice for
diagnosis and exclusion of toxoplasmosis, but it cannot determine the cause of disease showing meningitis
pattern.
Keywords: Computer tomography, Brain, HIV-patients
Ramathibodi Hospital and to evaluate accuracy of CT for the diagnosis of the brain lesion.
Material and Method: Data from first CT scan of the brain of 195 adult HIV patients at Ramathibodi Hospital
were reviewed. The final diagnoses from medical records were assessed followed by CSF analysis, pathological
report, and therapeutic treatment. The accuracy of the CT brain was evaluated using sensitivity, specificity,
positive predictive value (PPV) and negative predictive value (NPV).
Results: One hundred ninety five adult seropositive patients for HIV underwent CT scan of the brain, 59% were
HIV encephalopathy (HIVE), 22% toxoplasmosis, 9% cryptococcoma, 5% tuberculous meningitis, 4% tuberculoma,
3% progressive multifocal leukoencephalopathy (PML), 2% lymphoma, and 1% normal. In nonspecified
causes (from CT scan), 33% were meningitis, 4% cerebritis, and 5% infarction. CT was found to have
high sensitivity, specificity, PPV, and NPV for toxoplasmosis (92%, 96%, 86%, and 98%, respectively).
Conclusion: HIV encephalopathy was the most common finding of adult HIV brains. Toxoplasmosis was the
most common opportunistic parenchymal brain lesion in adult HIV brains. CT was the modality of choice for
diagnosis and exclusion of toxoplasmosis, but it cannot determine the cause of disease showing meningitis
pattern.
Keywords: Computer tomography, Brain, HIV-patients
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