Neuropathological changes in early HIV-1 dementia

Early pathological abnormalities in human immunodeficiency virus (HIV‐1)–related dementia have not been well documented. We report a homosexual man with fatigue and intermittent diarrhea in whom early HIV‐1–related dementia was demonstrated during neurological screening in the Multicenter AIDS Cohort Study. Within 4 months he died of massive epistaxis, and the brain revealed astrocytosis of white matter and mild pallor of myelin staining in the absence of inflammation, multinucleated giant cells, and brain atrophy.