Neurological syndromes occur in around 40–70% of HIV-infected people. Direct central nervous system involvement by the virus usually manifests as HIV encephalitis, HIV leucoencephalopathy, vacuolar leucoencephalopathy or vacuolar myelopathy. Indirect involvement is usually associated with neurotropic opportunistic infections which include tuberculosis, toxoplasmosis, cryptococcosis and viral encephalitis such as herpes simplex, varicella-zoster, cytomegalovirus and Human polyomavirus 2. We report a case of transverse myelitis in a recently diagnosed HIV patient who was otherwise asymptomatic initially and developed paraparesis after 1 month of initiation of antiretroviral therapy. After ruling out opportunistic infections and other causes of compressive and non-compressive myelopathy, development of transverse myelitis was attributed to immune reconstitution inflammatory syndrome in view of baseline low CD4 count and their improvement after HAART initiation. Prompt treatment with corticosteroids successfully reversed the symptoms.

大约 40-70% 的 HIV 感染者会出现神经系统综合征。病毒直接累及中枢神经系统通常表现为 HIV 脑炎、HIV 白质脑病、空泡性白质脑病或空泡性脊髓病。间接受累通常与嗜神经性机会性感染有关，包括结核病、弓形体病、隐球菌病和病毒性脑炎，如单纯疱疹、水痘带状疱疹、巨细胞病毒和人多瘤病毒 2. 我们报告了一例最近诊断出的 HIV 患者的横贯性​​脊髓炎病例，该患者最初无症状，并在开始抗逆转录病毒治疗 1 个月后出现下肢轻瘫。在排除机会性感染和压迫性和非压迫性脊髓病的其他原因后，鉴于基线低 CD4 计数及其在 HAART 开始后的改善，横贯性脊髓炎的发展归因于免疫重建炎症综合征。及时用皮质类固醇治疗成功地逆转了这些症状。