This patient is HIV positive and not on antiretroviral therapy and had a CD4 200 cells/μL.
HIV-1 encephalitis/encephalopathy (HIVE) results from direct HIV infection of the brain. Typically, and in this case, opportunistic infections are absent. Cognitive, behavioral, and motor abnormalities are typically present in 25-70% of cases. This patient presented with confusion. Imaging typically demonstrates atrophy with bilateral diffuse white matter abnormalities.