Two forms of immunological recovery and immune reconstitution inflammatory syndrome in one patient

Sarah L McGuinness, Joseph S Doyle and Alan C Street
Med J Aust 2012; 197 (2): . || doi: 10.5694/mja12.10678
Published online: 16 July 2012

To the Editor: A 38-year-old HIV-positive Somalian refugee with a past history of pulmonary tuberculosis (TB) and poor compliance with antiretroviral therapy (ART) presented with fever, lethargy and mediastinal lymphadenopathy. He was diagnosed with fully drug-sensitive lymph node TB. The CD4 lymphocyte count at TB diagnosis was 20/µL (reference interval, 350–2630/µL), and the HIV RNA viral load was 99 000 copies/µL. Standard anti-TB treatment was commenced, and ART was reinstated.

  • Royal Melbourne Hospital, Melbourne, VIC.



We thank Olga Vujovic and Irani Ratnam for their contribution to the care of this patient.

Competing interests:

No relevant disclosures.

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  • 3. Abdool Karim SS, Naidoo K, Grobler A, et al. Timing of initiation of antiretroviral drugs during tuberculosis therapy. N Engl J Med 2010; 362: 697-706.
  • 4. Abdool Karim SS, Naidoo K, Grobler A, et al. Integration of antiretroviral therapy with tuberculosis treatment. N Engl J Med 2011; 365: 1492-1501.


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