Recurrent cerebral infarcts as the first manifestation of infection with the HIV virus.

There is an increased risk of stroke in patients with HIV infection. One of the mechanisms is production of anticardiolipin (aCL) antibodies, induced by the virus. Many studies have documented a high incidence of aCL antibodies in patients with HIV infection and the increased risk of stroke, although there is no such correlation with other viruses that also stimulate production of aCL antibodies. Probably the HIV virus also stimulates production of other serum proteins, which together with aCL antibodies make procoagulation complexes, similar to the primary anticardiolipin syndrome. We present a case of a 40-year-old patient, hospitalized three times in our department because of recurrent ischemic strokes. Diagnostic tests revealed a high titre of anticardiolipin antibodies and the early stage of HIV infection. Recurrent ischemic strokes were the first manifestation of HIV infection in this patient.