Infections caused by the human immunodeficiency virus (HIV) and by the larvae of Taenia solium (i.e., cysticercosis) are still widespread in many developing countries. Both pathologies modify host immune status and it is possible that HIV infection may modulate the frequency and pathogeny of cysticercosis of the central nervous system (i.e., neurocysticercosis [NCC]). Objective: To describe published cases of NCC among HIV-positive patients and to evaluate whether the characteristics of NCC, including frequency, symptoms, radiological appearance, and response to treatment differed between HIV-positive and HIV-negative patients. Methods: Forty cases of NCC/HIV co-infected patients were identified in the literature. Clinical and radiological characteristics, as well as response to treatment, were compared with non-matching historical series of NCC patients without HIV infection. Results: Most of these patients had seizures and multiple vesicular parasites located in parenchyma. Clinical and radiological characteristics were similar between HIV-positive and HIV-negative patients with NCC, as well as between immunocompromised and non-immunocompromised HIV-positive patients. Conclusion: Our review did not reveal clear interactions between HIV and NCC. This may be partially due to the small number of cases and reliance on published research. A systematic, multi-institutional effort aiming to report all the cases of this dual pathology is needed to confirm this finding and to clarify the possible relationship between both pathogens.

Dear Editor, We thank Drs Joob and Wiwanitkit for their commentary on our paper 1. We agree with them-both neurocysticercosis (NCC) and human immunodeficiency virus (HIV) are not uncommon in many tropical countries and co-infection has only been reported sporadically. For this very reason, we reviewed all published cases of NCC and HIV co-infection to determine whether we could clarify their relationship 2. The study from Tanzania 3 was included in our study, and it suggested that HIV and NCC were not associated, as the prevalence of NCC was similar among HIV-positive and HIV-negative individuals. The autopsy study from Brazil 4 was also cited in our paper 2 and, effectively, as stated by Joob & Wiwanitkit, the fact that HIV/AIDS was the main underlying cause of death when NCC was an associated cause is compelling and highlights the need to better understand the relationship between these two infections.