A Prospective Study on Helical Computed Tomography in the Assessment of Gastrointestinal Lesions in HIV Patients

Helical computed tomography (HCT) helps early detection of gastrointestinal involvement and categorizes the lesions into infective and neoplastic etiologies. A quick institution of presumptive treatment reduces morbidity, hospital stay, etc. The study deals with the spectrum and frequency of gastrointestinal lesions in the abdomen of Human immunodeficiency virus (HIV) positive patients and correlates the gastrointestinal lesions with CD₄ count. A total of 40 patients with a known history of HIV infection and a recent CD₄ count were included in the study. After correlating the computed tomography (CT) scans with clinical history, available hematological, biochemical, histopathological, serological investigations, etc., the lesions were classified into infective and neoplastic lesions. The yield of abnormal abdominal computed tomography findings was 95%, and the remaining 5% were normal. Neoplastic lesions occur at very low (<CD₄ count 100 cells/µl) and narrow CD₄ count range of 50 – 100 cells/µL. The occurrence of infective lesions was at relatively higher CD₄ count than neoplastic lesions, but CD₄ count < 300 cells/µl and the narrow CD₄ count ranges for multiple liver abscesses was 34 - 200 cells/µl, multiple splenic abscesses were 6 – 300 cells/µl, infective slight bowel wall thickening was 35 - 250 cells/µl. Helical computed tomography is a ray of hope for the plight of HIV-positive patients in India. It serves as the most rapid, cost-effective, early, and efficient means of assessing the extent of gastrointestinal involvement in the abdomen of HIV-positive patients.