To investigate the clinical and pathological features of intracranial space occupying lesions in patients with acquired immune deficiency symptom (AIDS), and to improve the diagnosis and prognosis of AIDS patients with intracranial space occupying lesions.

The clinical manifestations, CD4⁺ T cell counts, cerebrospinal fluid examination and brain biopsy of AIDS patients complicated with intracranial space occupying lesions in Beijing Ditan Hospital, Capital Medical University from May 2013 to May 2017 were analyzed, retrospectively. The patients were divided into different groups according to number of CD4⁺ T lymphocytes in peripheral blood and different pathological types.

Patients with intracranial space occupying lesions accounted for 1.45% of the inpatients treated in the same period. The main clinical manifestations were fever, headache, vomiting, physical impairment (limb dysfunction) and conscious disturbance, etc. There were 16 (44.4%) patients with HIV encephalopathy, 12 (33.3%) patients with central nervous system infection, among the 12 patients, 6 (16.7%) cases with tuberculosis infection, 3 (8.3%) cases with fungus infection, 1 (2.8%) case with toxoplasma, 1 (2.8%) case with cytomegalovirus, 1 (2.8%) case with neurosyphilis, the other 8 patients with brain tumors, 4 patients were diffuse large B cell lymphoma, 3 patients were Burkitt lymphoma, one patient was oligodendroglioma. After treatment, 27 (75%) patients recovered completely or improved partially, 5 (13.9%) patients had no improvement and 4 (11.1%) patients died. There were 20 cases with CD4⁺ T cell counts lower were 50 cells/μl, 7 cases wer 50-100 cells/μl, 5 cases were 100-200 cells/μl, and 4 cases with CD4⁺ T cell counts higher than 200 cells/μl. Counts of CD4⁺ T cell in HIV encephalopathy were lower than opportunistic infection and tumor, but with no significant difference (F = 0.4, P = 0.31; F = 0.17, P = 0.26).

The pathological features of intracranial space occupying lesions in patients with AIDS were complicated, the incidence rate of HIV encephalopathy was the highest among intracranial space occupying lesions in patients with AIDS, complicated with opportunistic infection and tumor. For patients with AIDS, especially those whose CD4⁺ T lymphocyte counts were lower than 200 cells/μl, it was crucial to make definite diagnosis as early as possible by brain biopsy to improve the prognosis and curative rate.