Which condition is most likely diagnosed in an HIV-positive patient with memory loss, attention issues, and MRI showing white matter changes?

HIV-related dementia is characterized by cognitive impairments, including memory loss and difficulties with attention, particularly in patients with advanced HIV infection. The presence of white matter changes on MRI aligns with the pattern often seen in HIV-associated neurocognitive disorders, which can include HIV-related dementia as part of a broader spectrum of central nervous system complications related to viral infection.

In individuals with HIV, the progressive decline in cognitive function is due to several factors, including direct viral effects on the brain, opportunistic infections, and inflammatory responses. MRI findings typically show changes in the white matter, reflecting the demyelination and neuronal injury that can occur.

This diagnosis is especially relevant for anyone exhibiting cognitive issues in the context of an HIV-positive status. Other conditions listed might present with similar cognitive symptoms, but the overall clinical picture—memory loss, attention issues, and specific MRI findings—points most directly to HIV-related dementia as the cause in this scenario.