Reversal of apparent AIDS dementia complex following treatment with vitamin B₁₂

Abstract. The human immunodeficiency virus (HIV)‐associated dementia complex is characterized by difficulties in concentration and memory followed by apathy, social withdrawal and motor dysfunction. Decreased serum vitamin B₁₂ levels occur in up to 20% of patients with acquired immune deficiency syndrome (AIDS) and may adversely contribute to the haematologic and neurologic dysfunction which is frequently attributed to the human immunodeficiency virus. We describe a patient with AIDS who presented with an apparent advanced AIDS dementia complex. There was an associated low serum vitamin B₁₂ resulting from malabsorption due to low gastric intrinsic factor secretion. Following treatment with vitamin B₁₂ the symptoms resolved over a 2‐month period. We believe that the AIDS dementia complex represented a reversible adverse synergistic interaction between the human immunodeficiency virus and vitamin B₁₂ deficiency. 1993 Blackwell Publishing Ltd