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March 2001

A 10-year-old boy with transfusion-acquired HIV presents with changes in behavior and speech. He had been neurodevelopmentally normal and was doing well in school until approximately 3 months earlier, when he began to have noticeable behavioral changes, including violent outbursts and changes in speech. Currently he is mute and only minimally interactive with his family. He refuses to eat and has lost nearly 10 kg over the past two months. He no longer attends to his personal hygiene. The child is not currently receiving antiretroviral therapy. His most recent CD4+ lymphocyte count is less than 20 cells/uL. CT scan of the head is available for review.

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