{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:52:19Z","timestamp":1792453939501,"version":"4.5.0"},"reference-count":40,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background: Radiological imaging is crucial for diagnosing hepatic cystic echinococcosis (HCE) and assessing complications. Case studies suggest HCE with human immunodeficiency virus (HIV) co-infection is associated with larger, more multilocular cysts, increased extrahepatic dissemination, rupture, secondary infection and biliary invasion.\nObjectives: To compare the radiological presentation of HCE in HIV-positive (HIV+) and HIV-negative (HIV-) patients and determine whether HIV co-infection influences imaging features.\nMethod: Pre-operative imaging (chest X-rays, ultrasound, CT and MRI of HIV+ and HIV- HCE patients at our tertiary facility between 2011 and 2023 was reviewed. Cyst characteristics and disease staging (WHO and Gharbi classifications) were independently assessed by two blinded radiology specialists.\nResults: Eighty-six patients (45 HIV+, 63 females) were included. Single unilocular cysts predominated (37.8% HIV+ and 36.6% HIV-). Extrahepatic cysts occurred in 40% of HIV+ and 34.1% of HIV- patients. Right hepatic lobe involvement was more common in HIV+ patients (86% vs. 62.5%). Median cyst diameter was 14.2cm in HIV+ vs. 11.3cm in HIV- patients. Rates of biliary communication, bile duct dilatation, intraperitoneal cyst rupture and cyst infection were similar in HIV+ versus HIV- patients (11.1% vs 12.2%, 11.1% vs 17.1%, 20% vs. 26.8% and 8.9% vs. 19.5%, respectively), as was WHO and Gharbi stage distributions.\nConclusion: HIV prevalence (52.3%) exceeded the national prevalence (12.7%), supporting hypotheses that HCE may self-limit less frequently in HIV+ patients. However, co-infection was not associated with more advanced or complicated radiological disease.\nContribution: Imaging remains central to HCE diagnosis and management, particularly in HIV+ individuals, where serological testing is less reliable.<\/jats:p>","DOI":"10.4102\/sajr.v30i1.3493","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T07:31:01Z","timestamp":1787211061000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Imaging comparisons of cystic echinococcosis in HIV-positive and HIV-negative patients"],"prefix":"10.4102","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7196-5805","authenticated-orcid":false,"given":"Kate","family":"Couzens-Bohlin","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3957-2586","authenticated-orcid":false,"given":"Gercois","family":"Human","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00c879s84","id-type":"ROR","asserted-by":"publisher"}],"name":"Groote Schuur Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6780-2225","authenticated-orcid":false,"given":"Elsabe","family":"Smit","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00c879s84","id-type":"ROR","asserted-by":"publisher"}],"name":"Groote Schuur Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1405-474X","authenticated-orcid":false,"given":"Urda","family":"Kotze","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7057-9156","authenticated-orcid":false,"given":"Jake","family":"Krige","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-6879","authenticated-orcid":false,"given":"Christo","family":"Kloppers","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-8548","authenticated-orcid":false,"given":"Marc","family":"Bernon","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7052-7156","authenticated-orcid":false,"given":"Stefano","family":"Cacciatore","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/001575385","id-type":"ROR","asserted-by":"publisher"}],"name":"International Centre for Genetic Engineering and Biotechnology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0123-256X","authenticated-orcid":false,"given":"Eduard","family":"Jonas","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"ref0","unstructured":"WHO Team Control of Neglected Tropical Diseases (NTD). 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