Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria

Abstract

BackgroundThough the major target of the HIV-virus is the immune system, the frequency of abdominal disorders in HIV/AIDS patients has been reported to be second only to pulmonary disease. These abdominal manifestations may be on the increase as the use of antiretroviral therapy has increased life expectancy and improved quality of life. Ultrasonography is an easy to perform, non invasive, inexpensive and safe imaging technique that is invaluable in Africa where AIDS is most prevalent and where sophisticated diagnostic tools are not readily available. Purpose: To describe the findings and evaluate the clinical utility of abdominal ultrasonography in HIV/AIDS patients in Ibadan, NigeriaMethodsA Prospective evaluation of the abdominal ultrasonography of 391 HIV-positive patients as well as 391 age and sex-matched HIV-negative patients were carried out at the University College Hospital, Ibadan.ResultsOf the 391 cases studied, 260 (66.5%) were females; the mean age was 38.02 years, (range 15–66 years). The disease was most prevalent in the 4th decade with an incidence of 40.4%. Compared with the HIV-negative individuals, the HIV+ group of patients had a significantly higher proportion of splenomegaly (13.5% vs. 7.7%; p < 0.01), lymphadenopathy (2.0% vs. 1.3%; p < 0.70), and renal abnormalities (8.4% vs. 3.8%; p < 0.02). There were no differences in hepatic and pancreatic abnormalities between the HIV+ and HIV- groups. There were significantly fewer gallstones in the HIV+ group (1.4% vs. 5.1%; p < 0.01).ConclusionAIDS is a multi-systemic disease and its demographic and clinical pattern remains the same globally. Ultrasonography is optimally suited for its clinical management especially in Africa. Its accuracy and sensitivity may be much improved with clinico-pathologic correlation which may not be readily available in developing countries; further studies may provide this much needed diagnostic algorithms.

Correlation between Abdominal Ultrasonographic Findings and CD4 Cell Count in Adult Patients with HIV/AIDS in Jos, Nigeria

“…The frequency of abdominal disorders in HIV/AIDS patients has been reported to be second to pulmonary disease [2]. In the majority of the sub-Saharan African countries, the absence of computed tomography facilities makes abdominal ultrasound an attractive alternative diagnostic tool in the clinical investigation of infectious and non infectious complications of HIV infected individuals [24].…”

“…The degree of immunodeficiency is related to the level of the 4 CD + count and, as such, 4 CD + count is a good index for monitoring the disease's progression. Though the major target of the virus is the immune system, the frequency of abdominal disorders in HIV/AIDS patients has been reported to be second only to pulmonary disease [2]. Radiological procedures are essential in both diagnostic and interventional roles.…”

“…Africa where AIDS is most prevalent [2]. Abdominal Ultrasonography can be used to examine the abdominal organs including the liver, gallbladder, spleen, lymph nodes, pancreas and the kidneys which are commonly affected by opportunistic infections and malignancies [4].…”

Abdominal Sonographic Findings in Severely Immunosuppressed Human Immunodeficiency Virus-Infected Patients Treated for Tuberculosis

“…Variable incidences of hepatomegaly and splenomegaly in HIV-TB co-infection have been described ranging from 19% -85% [6] [7] [26] [27]. The most common encountered liver abnormality is a diffuse fatty-fibrotic pattern, often due to fatty degeneration of the liver.…”

“…Therefore, ultrasound examination of the abdomen has been used in a number of centers to assist in diagnosing disseminated TB in patients with advanced HIV disease. A number of ultrasonographic findings such as lymphadenopathies with a central hypo-echoic region and splenic micro-abscesses have been regarded useful in the diagnosis of TB [6] [7].…”