DEMENTIA AND A PARANOID SYNDROME AS THE F IRST MANIFESTATION OF AIDS

A 33-year-old HIV-1-positive man developed dementia and a paranoid sym ptomatology with auditory hallucinations as the first manifestation of AIDS. The immunodeficiency syndrome is currently represented only by the immunohistochemical findings (CD4 216/mu l; CD4/CD8 ratio 0.12); n o other manifestations of the disease are present. According to the li terature about 15% of patients suffering from AIDS are likely to devel op dementia during the course of the disease, usually after preceding opportunistic infections, severe systemic illness, or neoplasm. The ma nifestation of the disease solely by dementia is a rare phenomenon and represents, particularly if the incident of infection is cryptic, a d iagnostic challenge.