Clinical utility of abdominal CT scanning in patients with HIV disease

To evaluate the yield of abdominal computed tomography (CT) in patients with human immunodeficiency virus (HIV) infection and to assess the influence of CT scanning on patient management and diagnosis.

A retrospective analysis of 216 abdominal CT scans, performed on 156 patients (147 men, nine women; age range 22-57 years), between March 1992 and October 1994 was undertaken. Clinical information, including the indication for performing the scan and the eventual diagnosis, was obtained from the case notes and the contribution of CT scanning to patient management assessed.

Indications for CT fell into five main groups: investigation of pyrexia of unknown origin (PUO) (n = 82), staging and response to treatment of previously diagnosed neoplasms (n = 46), investigation of abdominal pain (n = 20), CT undertaken to clarify the results of other imaging investigations (n = 20) and miscellaneous indications (n = 48). An eventual diagnosis thought to account for the clinical presentation was made in 150 cases (68%), reflecting the high level of underlying pathology. CT contributed to patient management in a large proportion of cases (62%), but only led directly to a diagnosis in a minority (12%).

With the exception of patients presenting with PUO, abdominal CT remains an important investigation in the management of patients with HIV infection. In patients presenting with PUO a thorough infection screen should be undertaken prior to CT scanning. Whilst frequently contributing to patient management, CT rarely leads directly to a diagnosis.