Sporadic Creutzfeldt-Jakob disease in two clinically and virologically controlled Brazilian HIV patients who progressed rapidly to dementia: case reports and literature review

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Flávia Esper Dahy, Christina T. G. Novaes, Gabriela A. Bandeira, Laís F. Ramin, Augusto César Penalva de Oliveira, Jerusa Smid
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2021
• Subjects: HIV; Dementia; Prion disease; Creutzfeldt-Jakob disease; HAND; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/s1678-9946202163023; https://doaj.org/article/8f47d52eaf9f438a9275d303bbfdc220

ABSTRACT Human immunodeficiency virus (HIV)-associated neurocognitive disorders are the main cause of cognitive decline and dementia in people living with HIV (PLHIV). However, extensive workup should be done in patients with rapidly progressive dementia (RPD) and HIV, especially when secondary infection in the central nervous system (CNS) is ruled out. Sporadic Creutzfeldt-Jakob disease (sCJD) is the main cause of RPD in non-HIV patients. It is a fatal neurodegenerative condition caused by prions that mainly affects elderly patients. Our objective is to describe two cases of PLHIV presenting with controlled infections and sCJD, and to review the literature. Our patients were younger than expected for sCJD and one of them had a longer disease course. As aging is expected to occur earlier in PLHIV, sCJD must be excluded in younger PLHIV presenting with RPD and without CNS infection.