title: A Retrospective Cohort Study of Lesion Distribution of HIV-1 Infection Patients With Cryptococcal Meningoencephalitis on MRI: Correlation With Immunity and Immune Reconstitution.
abstract: The objective of this paper is to correlate the MRI distribution of cryptococcal meningoencephalitis in HIV-1 infection patients with CD4 T cell count and immune reconstitution effect.A large retrospective cohort study of HIV patients from multi-HIV centers in China was studied to demonstrate the MRI distribution of cryptococcal meningoencephalitis and its correlation with the different immune status.The consecutive clinical and neuroimaging data of 55 HIV-1-infected patients with cryptococcal meningoencephalitis collected at multi-HIV centers in China during the years of 2011 to 2014 was retrospectively analyzed. The enrolled patients were divided into 2 groups based on the distribution of lesions. One group of patients had their lesions at the central brain (group 1, n = 34) and the other group of patients had their lesions at the superficial brain (group 2, n = 21). We explored their MRI characterization of brain. In addition, we also compared their CD4 T cell counts and immune reconstitution effects between the 2 groups based on the imaging findings.No statistical difference was found in terms of age and gender between the 2 groups. The medians of CD4 T cell counts were 11.67 cells/mm (3.00-52.00 cells/mm) in group 1 and 42.00 cells/mm (10.00-252.00 cells/mm) in group 2. Statistical difference of CD4 T cell count was found between the 2 groups (P = 0.023). Thirteen patients in group 1 (13/34) and 12 patients in group 2 (12/21) received highly active antiretroviral treatment (HAART). Patients of group 2 received HAART therapy more frequently than patients of group 1 (P = 0.021).Central and superficial brain lesions detected by MR imaging in HIV-1-infected patients with cryptococcal meningoencephalitis are in correlation with the host immunity and HAART therapy.
authors.affiliation: From the Department of Radiology, Tianjin First Central Hospital (SX, MZ, TG), Tianjin; Department of Radiology, Youan Hospital Affiliated of Capital Medical University (XL, HL), Xitoutiao, Youan Menwai, Beijing; Department of Radiology, Zhengzhou Sixth People's Hospital (YS, LS), Zhengzhou, Henan Province; Department of Radiology, Guangzhou Eighth People's Hospital (JL), Guangzhou, Guangdong Province; Department of Radiology, Shengjing Hospital of China Medical University (SP), Shenyang, Liaoning Province; Department of Infection, Zhengzhou Sixth People's Hospital (JX, YS, QZ), Zhengzhou, Henan Province; Department of Radiology, Zhongnan Hospital of Wuhan University (ZL), Wuhan, Hubei Province; and Department of Radiology, Shenzhen Third People's Hospital of Guangdong Medical College (PL), Shenzhen, Guangdong Province.
authors.forename: Shuang
authors.initials: S
authors.lastname: Xia
authors.forename: Xueqin
authors.initials: X
authors.lastname: Li
authors.forename: Yanbin
authors.initials: Y
authors.lastname: Shi
authors.forename: Jinxin
authors.initials: J
authors.lastname: Liu
authors.forename: Mengjie
authors.initials: M
authors.lastname: Zhang
authors.forename: Tenghui
authors.initials: T
authors.lastname: Gu
authors.forename: Shinong
authors.initials: S
authors.lastname: Pan
authors.forename: Liucun
authors.initials: L
authors.lastname: Song
authors.forename: Jinsheng
authors.initials: J
authors.lastname: Xu
authors.forename: Yan
authors.initials: Y
authors.lastname: Sun
authors.forename: Qingxia
authors.initials: Q
authors.lastname: Zhao
authors.forename: Zhiyan
authors.initials: Z
authors.lastname: Lu
authors.forename: Puxuan
authors.initials: P
authors.lastname: Lu
authors.forename: Hongjun
authors.initials: H
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D002681:China; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008297:Male; D016919:Meningitis, Cryptococcal / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D008590:Meningoencephalitis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult