{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:38:43Z","timestamp":1776184723964,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,7,13]],"date-time":"2018-07-13T00:00:00Z","timestamp":1531440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Up to 20% of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010related focal brain lesion (<jats:styled-content style=\"fixed-case\">FBL<\/jats:styled-content>) diagnoses cannot be determined without invasive procedures. In such cases, brain biopsy is an important step in the evaluation algorithm. The aims of this study were to describe the clinical outcomes of patients with <jats:styled-content style=\"fixed-case\">FBL<\/jats:styled-content>, the proportion of diagnoses confirmed by brain biopsies and their aetiologies, and to analyse the proportion of patients in whom the biopsy motivated a change in therapeutic management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was performed. The data from clinical records of patients with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010related <jats:styled-content style=\"fixed-case\">FBL<\/jats:styled-content> admitted between January 2005 and December 2015 were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 137 patients were included in the study. The median age was 39 years [interquartile range (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>) 33\u201344.5 years]. The median <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 count was 54 cells\/\u03bcL (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 21\u2013124 cells\/\u03bcL). Cerebral brain biopsy was performed in 21.16% of patients (29 of 137); 68.9% of these individuals (20 of 29) were diagnosed by histology, with results of central nervous system (<jats:styled-content style=\"fixed-case\">CNS<\/jats:styled-content>) lymphoma in 20.6% (six of 29), progressive multifocal leucoencephalopathy in 6.8% (two of 29), toxoplasmosis in 6.8% (two of 29), tuberculoma in 6.8% (two of 29), and other diagnoses in 27.6% (eight of 29). In nine patients, the histology was nonspecific. In 75.8% of patients (22 of 29), the result of the biopsy led to a change in the therapeutic management. We did not observe higher rates of mortality related to the procedure. Overall mortality at 30 and 90 days was similar in patients who were and were not biopsied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this retrospective cohort study, cerebral biopsy was associated with significant adjustments in therapeutic management for a high percentage of patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12646","type":"journal-article","created":{"date-parts":[[2018,7,13]],"date-time":"2018-07-13T13:17:27Z","timestamp":1531487847000},"page":"673-678","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The role of brain biopsy in the clinical management of <scp>HIV<\/scp>\u2010related focal brain lesions"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5153-2611","authenticated-orcid":false,"given":"MC","family":"Acosta","sequence":"first","affiliation":[{"name":"HIV Unit JM Ramos Mej\u00eda Hospital Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Kundro","sequence":"additional","affiliation":[{"name":"HIV Unit JM Ramos Mej\u00eda Hospital Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Viloria","sequence":"additional","affiliation":[{"name":"HIV Unit JM Ramos Mej\u00eda Hospital Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Peress\u00edn Paz","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit JM Ramos Mej\u00eda Hospital Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Morello","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit JM Ramos Mej\u00eda Hospital Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Latorre","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit JM Ramos Mej\u00eda Hospital Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Seoane","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit JM Ramos Mej\u00eda Hospital Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Toibaro","sequence":"additional","affiliation":[{"name":"HIV Unit JM Ramos Mej\u00eda Hospital Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Losso","sequence":"additional","affiliation":[{"name":"HIV Unit JM Ramos Mej\u00eda Hospital Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-015-7713-8"},{"key":"e_1_2_6_3_1","series-title":"Mandell, Douglas and Bennett's","volume-title":"Principles and Practices of Infectious Diseases","author":"Koralnik I","year":"2012"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2015-312037"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2012.10.012"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2003.034348"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2013.05.006"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2016.08.014"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199511000-00005"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2013.03.008"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2011.08.014"},{"key":"e_1_2_6_12_1","first-page":"85","article-title":"Stereotactic brain biopsy in the diagnosis of focal brain lesions in AIDS","volume":"68","author":"Corti M","year":"2008","journal-title":"Medicina (B Aires)"},{"key":"e_1_2_6_13_1","unstructured":"JaureguiberryA BrugueraJ LossoM.Systematics of CNS lesions. 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