Diagnostic Assessment & Prognosis An individual with human immunodeficiency virus, dementia, and central nervous system amyloid deposition

Human immunodeficiency virus (HIV)‐associated neurocognitive disorder (HAND) is found in 30%‐50% of individuals with HIV infection. To date, no HIV1 individual has been reported to have a positive amyloid PET scan. We report a 71-year-old HIV1 individual with HAND. Clinical and neuropsychologic evaluations confirmed a progressive mild dementia. A routine brain MRI was normal for age. [18F]Fluorodeoxyglucose‐PET revealed mild hypermetabolism in bilateral basal ganglia and hypometabolism of bilateral parietal cortex including the posterior cingulate/precuneus. Resting state functional MRI revealed altered connectivity as found with individuals with mild AD. CSF examination revealed a low Ab42/tau index but a low phospho-tau. An amyloid PET/CT with [18F]florbetaben revealed pronounced cortical radiotracer deposition. This case report suggests that progressive dementia in older HIV1individuals may be due to HAND, AD, or both. HIVinfection does not preclude CNS Ab/amyloid deposition. Amyloid PET imaging may be of value in distinguishing HAND from AD pathologies. 2016 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer’s Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).