Astrocytoma in Patients with HIV—Review of the Literature and Case Report

Astrocytomas are among the most common primary tumors of the central nervous system, arising from astrocytic glial cells and encompassing a wide spectrum of histopathological grades and clinical behaviors. Human immunodeficiency virus (HIV) infection is characterized by chronic immune dysregulation, neuroinflammation, and increased susceptibility to both opportunistic infections and malignancies. The management of astrocytomas in patients living with HIV presents unique clinical challenges but should, whenever feasible, follow standard neuro-oncological principles. We report the case of a 34-year-old man with well-controlled HIV infection who presented in February 2025 with progressive neurological symptoms. Brain imaging revealed a left temporo-insular lesion, and the diagnosis was confirmed by neuronavigation-guided biopsy performed on 31 March 2025. Histopathological and immunohistochemical evaluation established the diagnosis of an isocitrate dehydrogenase (IDH) wild-type astrocytoma, central nervous system (CNS) World Health Organization (WHO) grade 2, according to the 2021 classification of central nervous system tumors.