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.
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1. French MA. Immune reconstitution inflammatory syndrome: immune restoration disease 20 years on. Med J Aust 2012; 196: 318-321.
- 2. Blanc FX, Sok T, Laureillard D, et al; CAMELIA Study Team. Earlier versus later start of antiretroviral therapy in HIV-infected adults with tuberculosis. N Engl J Med 2011; 365: 1471-1481.
- 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.
We thank Olga Vujovic and Irani Ratnam for their contribution to the care of this patient.
No relevant disclosures.