Abdominal CT features and survival in acquired immunodeficiency.
OBJECTIVE
HIV-infected patients show a high incidence of abdominal disease. This investigation was made to determine whether abdominal CT provided prognostically relevant information in these patients.


METHODS
Images from 533 abdominal CT examinations in 339 HIV-infected patients were retrospectively reviewed for signs of abdominal disease, and correlated with clinical data and survival rates. The Kaplan-Meier analysis and rank testing of survival, and proportional hazards regression were used to define prognostic clinical and imaging findings.


RESULTS
Of the 339 patients, 278 (82%) showed abnormal abdominal findings on CT. Median survival was 29 months. Of the imaging findings, hepatic masses (n = 11), pathologically enlarged lymph nodes (n = 48), and ascites (n = 7) were associated with poor survival, giving a median survival of respectively 13 months, 15 months, and less than 1 month. These three features showed no association with CD4(+)-T-lymphocyte count or CDC category. Main determinants of survival were a low CD4(+)-T-lymphocyte count, and certain abnormal CT findings. Splenomegaly (n = 147), hepatomegaly (n = 144), and lymphadenopathy (n = 111) were the most common abdominal findings on CT but lacked prognostic relevance.


CONCLUSIONS
Abdominal CT offered prognostic implications in HIV-infected patients and might serve in risk stratification in selected patients. CT features such as hepatic masses, grossly enlarged lymph nodes, or ascites indicate advanced immunosuppression.
Knollmann
F D
FD
Department of Radiology, Virchow Hospital, Faculty of Medicine, Humboldt University of Berlin, Germany.
Mäurer
J
J
Grünewald
T
T
Schedel
H
H
Vogl
T J
TJ
Pohle
H D
HD
Felix
R
R
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D001201:Ascites / Q000000981:diagnostic imaging; D018791:CD4 Lymphocyte Count; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006529:Hepatomegaly / Q000000981:diagnostic imaging; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008107:Liver Diseases / Q000150:complications / Q000000981:diagnostic imaging; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D018570:Risk Assessment; D013163:Splenomegaly / Q000000981:diagnostic imaging; D015996:Survival Rate; D014057:Tomography, X-Ray Computed