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increased mortality rates in patients with IE and cirrhosis is required.We report a case of a 63-year-old African American female patient with a past medical history of treatment naïve human immunodeficiency virus (HIV). She was referred to our hospital with altered mental status and rigidity with a history of progressive ambulation difficulties and decreased verbal output over the previous months as reported by her son. Her clinical presentation and brain MRI were consistent with HIV encephalopathy with bilateral basal ganglia