49 year-old male with HIV; now with moderate lower extremity weakness

H&E. There are scattered inflammatory infiltrates, most of which are macrophages invading necrotic fibers.

Diagnosis: HIV-associated myopathy. The findings are of a nonspecific myopathic process. The main differential diagnosis in this setting is HIV myopathy (i.e., myopathy due to the viral infection itself) versus AZT (ziduvodine) myopathy. The latter appears similar to mitochondrial myopathies, with ragged red fibers, which were not seen here. This page created on a Macintosh using PhotoPage by John A. Vink.