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Neurology 2000;54:993-997
© 2000 American Academy of Neurology
Brief Communications

Role of brain biopsy in the management of focal brain lesions in HIV-infected patients

A. Antinori, MD, A. Ammassari, MD, R. Luzzati, MD, A. Castagna, MD, R. Maserati, MD, G. Rizzardini, MD, A. Ridolfo, MD, M. Fasan, MD, E. Vaccher, MD, G. Landonio, MD, M. Scerrati, MD, A. Rocca, MD, G. Butti, MD, A. Nicolato, MD, A. Lazzarin, MD, U. Tirelli, MD and for the Gruppo Italiano Cooperativo AIDS & Tumori

From the Department of Infectious Diseases (Dr. Antinori), IRCCS L. Spallanzani, Rome; the Departments of Infectious Diseases (Dr. Ammassari) and Neurosurgery (Dr. Scerrati), Catholic University Rome; the Institute of Immunology and Infectious Diseases (Dr. Luzzati), and the Department of Neurosurgery (Dr. Nicolato), University Hospital Verona; the Departments of Infectious Diseases (Drs. Castagna and Lazzarin) and Neurosurgery (Dr. Rocca), IRCCS S. Raffaele Hospital, Milano; the Departments of Infectious Diseases (Dr. Maserati) and Neurosurgery (Dr. Butti), IRCCS Policlinico S. Matteo Pavia; the Departments of Infectious Diseases I (Dr. Rizzardini) and III (Dr. Fasan), L. Sacco Hospital Milano; the Institute of Infectious Diseases and Tropical Medicine (Dr. Ridolfo), University of Milan, L. Sacco Hospital Milano; the Division of Medical Oncology and AIDS (Drs. Vaccher and Tirelli), Centro di Riferimento Oncologico IRCCS Aviano; and the Department of Infectious Diseases (Dr. Landonio), Niguarda Hospital Milano, Italy.

Address correspondence and reprint requests to Dr. Adriana Ammassari, Department of Infectious Diseases, Catholic University, L.go A. Gemelli, 8 00168 Rome, Italy; e-mail: a.ammassari{at}iol.it

In this multicenter, retrospective study of 160 brain biopsies in the assessment of HIV-related focal brain lesions, diagnostic sensitivity was acceptable (87%), but the procedure carried considerable morbidity (7.5%) and mortality (3.1%). Moreover, it is not always possible to initiate the changes in therapy indicated by the results, and overall survival remains poor, with a median of 2 months. Criteria for brain biopsy for the diagnosis of focal brain lesions should be redefined to include selected patients for whom a less invasive approach does not yield a definitive diagnosis.

Key words: Brain biopsy—Focal brain lesion—HIV




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