A case study presented at the presented at the American Academy of Neurology (AAN) 2015 meeting describes an HIV-positive patient who experienced a hemorrhagic stroke due to replication of the varicella zoster virus within his brain.

Murray Flaster, MD, PhD, of Loyola University Medical Center in Maywood, IL, and colleagues reported on a 48-year-old male patient with HIV/AIDS who presented with a very high HIV load and very low CD4 count. The patient had been prescribed highly active antiretroviral therapy but had not taken the regimen for the past seven years. He experienced a sudden weakness on the right side and difficulty speaking and understanding speech; imaging scans indicated that he had suffered a hemorrhagic stroke with bleeding directly into the substance of the brain, which the researchers were able to show was due to the varicella zoster virus actively replicating within the patient’s brain.

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After receiving treatment for varicella zoster virus and highly active antiretroviral therapy, the patient made an excellent recovery. The authors conclude that physicians who treat patients with suppressed immune systems should take into account the possibility of infection by the varicella zoster virus, which may cause strokes in children and adults in this population. In addition, lesions caused by the varicella zoster virus can mimic lesions caused by the John Cunningham virus (JCV) on imaging scans.

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