Unusual presentation and course of HIV-1 progressive encephalopathy

The present report concerns a vertically human immunodeficiency virus type 1 (HIV-l)-infected 7-year-old child, in whom a neurodegenerative disease oc curred after an acute neurologic disorder that was in all likelihood sympto matic of HIV-1 encephalitis. At the steady state the neurologic disease ful filled the accepted criteria of HIV-related progressive encephalopathy of c hildhood and was characterized by involvement of multiple neural systems an d subcortical dementia, The neurologic disease displayed, however, atypical presentation and course, and its acute focal onset led the authors to post ulate an acute and direct involvement of the brain in HIV-1 infection. The correlation between the cliniconeuroradiologic data and levels of HIV-RNA i n the cerebrospinal fluid and the response to different antiretroviral trea tments are also discussed. (C) 1999 by Elsevier Science Inc. All rights res erved.