A PATHOLOGICALLY DISTINCT NEW FORM OF HIV-ASSOCIATED ENCEPHALOPATHY

We present the clinical, morphological and neuropathological findings in a 44-year-old male suffering from the acquired immunodeficiency syn drome (AIDS) (CDC stage IV C2) who presented with rapidly progressive right-side hemiparesis and developed hemianopia and aphasia. Scans sho wed multiple, not contrast-enhancing, not space-occupying echo-intensi ve lesions in T2-weighted MR-imaging. No hint for an opportunistic inf ection, necrotizing vasculitis or vascular disease was found. All ther apeutic regimens failed and 8 weeks after onset of neurological sympto ms the patient died because of cardiorespiratory arrest. Post-mortem e xamination excluded opportunistic infection, progressive multifocal le ukoencephalopathy, lymphoma, vasculitis and ischemia of the brain. In the presence of an unusually high amount of HIV-infected macrophages a t immunohistochemical examination, the overall pathological findings w ere atypical both for HIV encephalitis and HIV leukoencephalopathy. We describe a pathologically distinct new form of HIV associated encepha lopathy.