Imaging Appearance of Human Immunodeficiency Virus Encephalitis on the Diffusion Weighted Images: A Case Report

Abstract

Human immunodeficiency virus (HIV) can cause many neurological diseases. HIV-related neurological disorders can be classified as direct and indirect complications. The former are complications caused by the virus itself such as acquired immunodeficiency syndrome (AIDS)-related dementia, HIVrelated seizures, and distal symmetric sensory polyneuropathy. The indirect complications include autoimmune disorders, opportunistic infections, and malignancies (1). HIV encephalitis is a direct complication. HIV, being neurotrophic, causes encephalitic illness in up to 60% of patients with AIDS (1). HIV encephalitis is a direct consequence of HIV infecting the brain itself. AIDS patients with HIV encephalitis frequently present other AIDS-related intracranial abnormalities, including other infections. However, HIV encephalitis should not combine with other opportunistic infection evidence. Although the pathophysiology of HIV encephalitis and the direct effects of this disease on the brain remain poorly understood, demyelination and gliosis preferentially affect the deep white matter of the centrum semiovale (2). Most studies of HIV encephalitis cases have reported findings based on the T2 weighted and fluid attenuated inversion recovery (FLAIR) images (1, 3-5). To our knowledge, there are no previous reports of HIV encephalitis appearing on diffusion weighted images. Here, we report on findings of diffusion weighted images from a patient with HIV encephalitis.