Ischemic cerebrovascular accident in an HIV patient: Neurosyphilis and antiphospholipid syndrome

HIV infection is a risk factor for the development of cardiovascular diseases including ischemic strokes, for which there are different multiple etiologies in these patients. We present the case of a 27-year-old man with AIDS, with an ischemic stroke in the left middle cerebral artery territory. Laboratory studies confirmed the diagnosis of neurosyphilis but also the existence of antiphospholipid antibodies. Seven months after the treatment of neurosyphilis, anticoagulation and antiretroviral therapy, the persistence of antiphospholipid antibodies was confirmed. The diagnostic approach to a vascular stroke in people with HIV is a challenge since there may be multiple etiologies. The relevance of antiphospholipid antibodies in these patients is a matter of debate and should be considered depending on the clinical scenario.