Lee Eun J, Kim Young H, Lee Jeong Y, Sunwoo Jun-Sang, Park Se Y, Kim Tae H
1 Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
2 Department of Neurology, Soonchunhyang University Hospital, Seoul, Korea.
Int J STD AIDS. 2017 Sep;28(10):1041-1044. doi: 10.1177/0956462417693734. Epub 2017 Feb 15.
Human immunodeficiency virus (HIV)-1 directly affects the nervous system, causes distinct neurological symptoms, and indirectly results in opportunistic infections, which include herpes virus simplex (HSV)-1, HSV-2, varicella zoster virus, and cytomegalovirus encephalitis caused by immunodeficiency. Early HIV-1 invasion of the central nervous system is also possible, and acute encephalopathy is a potentially lethal complication. We encountered a case of fulminant encephalopathy as a primary presentation of acute HIV-1 infection, in which highly active antiretroviral treatment resulted in a full clinical recovery. This case highlights the importance of considering acute HIV-1 infection in the differential diagnosis of reversible encephalopathy.
人类免疫缺陷病毒1型（HIV-1）直接影响神经系统，引发明显的神经症状，并间接导致机会性感染，其中包括单纯疱疹病毒1型（HSV-1）、HSV-2、水痘带状疱疹病毒以及由免疫缺陷引起的巨细胞病毒性脑炎。HIV-1也有可能早期侵入中枢神经系统，急性脑病是一种潜在的致命并发症。我们遇到了一例以暴发性脑病为急性HIV-1感染主要表现的病例，其中高效抗逆转录病毒治疗使患者临床完全康复。该病例突出了在可逆性脑病鉴别诊断中考虑急性HIV-1感染的重要性。
