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A 33-year-old HIV-seropositive man presented with recurrent oral candidiasis, weight loss, and lymphadenopathy.1 CD4 count was 73 cells/ml, and viral load was 296 000 copies/ml. Zidovudine, lamivudine and efavirenz were started, after which the patient showed an increase in CD4 count to 444 cells/ml. In the following weeks he developed progressive paresis of his left arm, left-sided facial weakness, bulbar dysarthia and dysphagia, which remitted when highly active antiretroviral therapy (HAART) was discontinued. However, his condition worsened again on resumption of HAART. Laboratory results showed a CD4 count of 441 cells/ml, a viral load of 105 copies/ml, a C reactive protein concentration of 18 mg/l and a sedimentation rate of 107 mm in the first hour. Serological tests for hepatitis B, hepatitis C and syphilis were negative, as were those for ANA, ANCA, rheumatoid factor and cryoglobulins. Complement (CH50) was …
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