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HIV encephalopathy in a child in the presence of a high CD4 count: a rare presentation

S Das1, S Joardar, S Bhattacharyya

  • 1Medical College and Hospital, Kolkata, India. shubhadeepnrsdoc@gmail.com

International Journal of STD & AIDS
|March 3, 2011
PubMed

Insights

A young girl experienced developmental delays and was diagnosed with HIV. Brain imaging revealed basal ganglia calcification and atrophy, indicating HIV encephalopathy despite a normal CD4 count, a rare occurrence.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Human Immunodeficiency Virus (HIV) infection can affect the central nervous system.
  • HIV encephalopathy is a known complication, typically associated with lower CD4 counts.

Observation:

  • A two-year-old girl presented with a three-month history of developmental regression.
  • The patient was diagnosed with HIV but maintained a normal CD4 lymphocyte count.
  • Brain imaging revealed bilateral basal ganglia calcification and cortical atrophy.

Findings:

  • The clinical presentation and neuroimaging findings led to a diagnosis of HIV encephalopathy.
  • This diagnosis was made despite the patient's normal CD4 count, which is highly unusual.

Implications:

  • This case highlights that HIV encephalopathy can occur even with preserved immune function (normal CD4 count).
  • It underscores the importance of considering neurological complications in HIV-infected children, irrespective of CD4 status.
  • Further research may be needed to understand the mechanisms of HIV encephalopathy in the context of normal CD4 counts.

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