Central nervous system involvement is commonly seen in persons living with HIV infection (PLHIV), with up to 2 – 10% presenting as intracranial mass lesions. The management of these lesions depends largely on their etiology and their relative frequency in the local population.
We performed a retrospective chart review of HIV patients with evidence of intracranial mass lesion/s on cranial MRI or CT scan who were seen at our institution from 2007 – 2018. Data on demographics, clinical features, etiology, surgical management and outcomes were collected.
The prevalence of intracranial mass lesions in our cohort was 2.2% (45/2,032). Patients were predominantly male (98%), with a mean age at diagnosis of 28 years. The most common clinical manifestations were headache (75%), focal weakness (49%), and seizures (32%). The most common diagnoses were toxoplasma encephalitis (51%) and tuberculosis (24%). Biopsy or excision was performed in 10% of cases, leading to a definitive diagnosis in 60% of these cases. A favorable outcome was observed in 58% of all patients at 46 months median follow-up with adequate disease-specific treatment.
The prevalence of intracranial mass lesions in Filipino PLHIV is 2.2%. The most common etiology was toxoplasma encephalitis (51%) and tuberculosis (24%). This is substantially different from that reported in the literature, and should be considered in formulating guidelines for our local population.

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References

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