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New-Onset Mania in the Setting of Progressive HIV Infection: A Case Report
Benjamin Walsh1, Benjamin Kalivas2
1Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA. walshbe@musc.edu.
The Journal of Behavioral Health Services & Research
|December 25, 2025
Summary
This case study highlights new-onset bipolar disorder in an HIV-positive patient. Early diagnosis and treatment of mania in HIV infection are crucial for patient stability.
Area of Science:
- Neuroscience
- Infectious Diseases
- Psychiatry
Background:
- Human Immunodeficiency Virus (HIV) infection is linked to psychiatric symptoms.
- Mania can manifest as part of bipolar disorder or as a distinct condition in HIV-infected individuals, previously termed AIDS mania.
Purpose of the Study:
- To present a case of new-onset bipolar disorder in a patient with HIV infection.
- To discuss the management of mania in the context of HIV and opportunistic infections.
Main Methods:
- Case report of a 57-year-old male patient.
- Clinical observation and treatment of manic symptoms and opportunistic infections.
Main Results:
- Patient presented with new-onset mania and was diagnosed with HIV infection (CD4+ count above AIDS threshold).
- Mood stabilization achieved with valproic acid and olanzapine.
- Developed cryptococcal pneumonia, treated with fluconazole.
Conclusions:
- Mania can occur in HIV infection even before the advanced stages of the disease.
- Integrated management of psychiatric and infectious complications is essential for HIV patients.
- This case underscores the importance of considering psychiatric manifestations in HIV care.
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