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Case report

Successful treatment of Epstein–Barr virus encephalitis in the setting of HIV-associated neurocognitive disorder: a diagnostic and therapeutic challenge

Janine M Trevillyan, Andrew A Mahony, Catriona McLean, Jennifer F Hoy

Corresponding author name: Janine M Trevillyan
Corresponding author e-mail: j.trevillyan@alfred.org.au

Citation: Antiviral Therapy 2013; 18:257-261
doi: 10.3851/IMP2451

Date accepted: 23 July 2012
Date published online: 06 November 2012

Abstract

We report a challenging case of HIV-associated neurocognitive disorder with superimposed Epstein–Barr virus (EBV) encephalitis. The patient presented with an abnormal MRI brain scan, and EBV DNA that was detected in the cerebrospinal fluid and brain biopsy, which also demonstrated histopathological findings consistent with the diagnosis. This occurred on the background of a 12-month period of gradual cognitive decrease secondary to HIV-associated dementia. Invasive testing was required to reach the diagnosis in this case, highlighting the importance of thorough investigation of neurological impairment in HIV-positive patients. Clinicopathological recovery was achieved through optimization of antiretroviral therapy and use of valganciclovir.

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