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Donald H. Gilden, MD; Maria Nagel, MD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Tipping and colleagues¹ discuss human immunodeficiency virus (HIV) as a cause of arterial disease with aneurysm and stroke. However, there is absolutely no scientific evidence that HIV causes vasculopathy. Furthermore, the authors' statement that herpes simplex virus, cytomegalovirus, and Epstein-Barr virus affect cerebral blood vessels is unfounded. Varicella zoster virus (VZV) is the only human virus that has been proven to cause vasculopathy.² Both aneurysm³ and breakdown of the internal elastic lamina in cerebral arteries² have been described in VZV vasculopathy.

Given the well-documented increased incidence of multiple neurological disorders (zoster, myelitis, retinal necrosis, and vasculopathy) produced by VZV reactivation in HIV-positive individuals, this is quite likely a case of VZV vasculopathy. In the case of Tipping and colleagues,¹ diagnosis could have been confirmed by detection of anti-VZV IgG antibody in cerebrospinal fluid.⁴ Furthermore, since an autopsy was performed, it would have been . . . [Full Text of this Article]

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RELATED LETTER

Stroke Caused by Human Immunodeficiency Virus–Associated Vasculopathy?—Reply
Brent Tipping, Linda de Villiers, Sally Candy, and Helen Wainwright
Arch Neurol. 2007;64(5):763.
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Stroke Caused by Human Immunodeficiency Virus–Associated Intracranial Large-Vessel Aneurysmal Vasculopathy
Brent Tipping, Linda de Villiers, Sally Candy, and Helen Wainwright
Arch Neurol. 2006;63(11):1640-1642.
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