Abstract
Background: Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imaging (MRI) plays an important role in the early detection of lesions. This work aimed to describe the MRI aspects of different brain lesions occurred in HIV positive patients in our practice. Methods: This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. Results: Among the 39 patients included, 19 (48.7%) had a previous brain CT scan, 11 of which were normal (28.2%). Thirty-five (89.74%) patients had a pathological MRI. The main etiologies found were toxoplasmosis (37.14%), tuberculosis (17.14%), cerebral atrophy (17.14%) and HIV encephalitis (14.28%). Among the eleven patients with a normal Computer Tomography scan, the MRI found 7 abnormalities including 1 case of toxoplasmosis, 3 cases of HIV encephalitis and 3 cases of Progressive Multifocal Leukoencephalopathy (PML). Conclusion: MRI played an important role in the diagnosis of CNS disorders in HIV-infected individuals. It can be used to differentiate and characterize various brain lesions. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV.
Highlights
Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with about 25.5 million cases, or 70% of the global burden of this disease [1]
Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV
We carried out an exhaustive sampling by systematic census of all HIV-positive patients referred for Magnetic Resonance Imaging (MRI) on suspicion of Central Nervous System (CNS) involvement on the basis of clinical and/or biological arguments, and who may or may not have had a previous brain scan
Summary
Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with about 25.5 million cases, or 70% of the global burden of this disease [1]. Morbid manifestations of the Central Nervous System (CNS) can occur at all stages of HIV infection, in the AIDS disease stage Their prevalence varies from 40% to 70% according to clinical studies and even reaches 100% in some autopsy series [2]. Methods: This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV
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