Lacunar Infarction as a Neurological Manifestation of Human Immunodeficiency Virus (HIV): A Case Report

Human immunodeficiency virus (HIV) belongs to the Lentivirus genus of the Retroviridae family. The virus primarily attacks CD4+ T-lymphocyte helper cells, which results in severe immunological suppression and ongoing cell death. HIV has several neurological manifestations, including meningitis, epileptic seizures, and stroke. A 35-year-old male presented with an eight-month history of fever, convulsion, and weight loss. Neurological exam was significant for bilateral upgoing plantar response and neck stiffness. The enzyme-linked immunosorbent assay (ELISA) was positive for HIV, and his brain MRI revealed a hyperintense signal in the head of the right caudate nucleus, right basal ganglia, left basal ganglia, and left frontoparietal subcortical white matter, suggestive of an acute lacunar infarct. HIV patients with neurological complaints, especially those with convulsions, require careful evaluation and direct input from neurologists and infectious disease specialists. HIV as a potential cause of stroke in the young population, especially in low-income countries, should not be overlooked due to its notorious effect on the central nervous system (CNS) and overall health.