P-OT022. Neuroimaging features of HIV-positive patients with central nervous system infection in Dr Sardjito Hospital, Yogyakarta, Indonesia

Introduction. Central Nervous System (CNS) infection, including meningitis and encephalitis, is a life-threatening disease, especially in developing countries. The aetiologies are bacterial, viral, fungal, or parasite needing different treatments. Patients with HIV positive are at higher risk for the development of CNS infections. Neuroimaging, such as Head CT scan and MRI, is important to help the diagnosis. This study is to describe the features of neuroimaging related to the diagnosis in HIV-positive patients with CNS infection. Methods. A retrospective descriptive design was used in this study. Sixty adult patients confirmed for HIV-positive with CNS infection were described for the neuroimaging features (Head CT scan and MRI) and related diagnoses. The data was collected from January 2019 until September 2020 in Dr Sardjito hospital. Results. The prevalence of HIV-positive in CNS infection was 36% (2019 in Dr Sardjito Hospital). The most common neuroimaging features was pathological enhancement found in 30 cases (50%). The second feature was cerebral edema (27 cases, 45%), followed by abscess (18 cases, 30%). The other features were focal mass lesion 25%, hydrocephalus 21.6%, cerebral atrophy 13.3%, cerebral infarct 13.3%, tuberculoma 13.3%, midline shift 13.3%, hemorrhagic 1.6%, and normal finding in 11.6%. The diagnoses found in pathological enhancement were cerebral toxoplasmosis (13 patients, 43%), cerebral abscess (8 patients, 26.6%), bacterial meningitis/encephalitis (6 patients, 20%), and unspecified meningitis/encephalitis. The same diagnoses presented in feature of cerebral edema. However, the abscess feature was mostly found in cerebral abscess (9 patients, 50%), cerebral toxoplasmosis (6 patients, 33%), and bacterial meningitis/encephalitis (3 patients, 17%). The other features showed a variety of diagnoses. Conclusion. HIV-positive infection showed various features of neuroimaging. The most common features were pathological enhancement, cerebral edema, and abscess. Cerebral toxoplasmosis, cerebral abscess, and bacterial meningitis/encephalitis were the most common diagnoses in HIV-positive patients with CNS infection.