ABDOMINAL CT FEATURES AND SURVIVAL IN ACQUIRED IMMUNODEFICIENCY

Purpose: HIV-infected patients show a high incidence of abdominal dise ase. This investigation was made to determine whether abdominal CT pro vided prognostically relevant information in these patients. Material and Methods: Images from 533 abdominal CT examinations in 339 HIV-infe cted patients were retrospectively reviewed for signs of abdominal dis ease, 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 findin gs. 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), a nd ascites (n=7) were associated with poor survival, giving a median s urvival of respectively 13 months, 15 months, and less than 1 month. T hese three features showed no association with CD4(+)-T-lymphocyte cou nt or CDC category. Main determinants of survival were a low CD4(+)-T- lymphocyte count, and certain abnormal CT findings. Splenomegaly (n=14 7), hepatomegaly (n=144), and lymphadenopathy (n=111) were the most co mmon abdominal findings on CT but lacked prognostic relevance. Conclus ion: Abdominal CT offered prognostic implications in HIV-infected pati ents and might serve in risk stratification in selected patients. CT f eatures such as hepatic masses, grossly enlarged lymph nodes, or ascit es indicate advanced immunosuppression.