Relapsing and remitting human immunodeficiency virus—associated leukoencephalomyelopathy

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Abstract
We describe a 33‐year‐old homosexual man with a steroid‐responsive, remitting and relapsing leukoencephalopathy associated with recent human immunodeficiency virus type 1 (HIV‐1) seroconversion. Biopsy of a parieto‐occipital lesion revealed demyelination and astrogliosis with focal necrosis. Detailed investigations demonstrated no pathogens in the brain other than HIV‐1. This patient illustrates that a neurological disorder clinically indistinguishable from multiple sclerosis may be the presenting manifestation of HIV‐1 infection and may occur in the absence of clinically significant immunosuppression.