Dados do Trabalho

Título

Imaging patterns of HIV related central nervous diseases

Introdução e objetivo(s)

Involvement of the central nervous system (CNS) by human immunodeficiency virus (HIV) derives from both direct viral action and opportunistic infections (OI) associated with acquired immunodeficiency syndrome (AIDS). HIV encephalopathy may be identified as a manifestation of direct viral involvement. Progressive multifocal leukoencephalopathy (LEMP), CNS toxoplasmosis (toxo-CNS), cryptococcosis, CNS tuberculosis, are configured as some opportunistic infections of relevant incidence. With antiretroviral therapy (ART) and its consequent treatment for AIDS, there is a decrease in patients' susceptibility to present opportunistic infections. However, after starting ART, it is possible to
identify manifestations derived from inflammatory immune reconstitution syndrome
(SIRI). HIV-related primary CNS lymphoma (PCNSL) is the main identifiable neoplasm in this condition.
We aim to describe characteristical imaging findings of patients with CNS involvement associated with HIV in order to use an established pattern of recognition of different types of diseases related to HIV.

Método(s)

A pictorial review of patients with neuroradiological manifestations derived from of HIV by magnetic resonance (MR) and computed tomography (CT) in a tertiary center.

Discussão

Patterns recognition on MRI according to distribution criteria are diffuse bilateral, focal and meningitis/meningoencephalitis.
HIV encephalopathy presents as diffuse bilateral pattern with symmetrical attenuation of periventricular location. While PML, PCNSL and toxo-CNS show focal patterns. Within the meningeal/meningoencephalitis pattern, CNS cryptococcus, CNS tuberculosis, and CNS varicella are some common forms of interest. Vasculitis form of presentation is not included in this pattern and constitutes a variant of consideration regarding its outcome in morbidity.

Conclusões

The identifiable imaging patterns in HIV allow us to infer direct viral involvement, opportunistic infections or ART consecutive changes.

Palavras Chave

vírus HIV; Brain MRI; Neuroimaging

Arquivos