Paradoxically high rise in CD4 lymphocyte count in the immune reconstitution inflammatory syndrome in a patient with tuberculosis and HIV infection

The number of patients with HIV infection in the Russian Federation is increasing, which requires wider implementation of antiretroviral therapy and, accordingly, criteria for assessing its effectiveness. Purpose of the study. To present for consideration a clinical case of tuberculosis combined with HIV infection, with a paradoxically high increase in the number of CD4 lymphocytes in the inflammatory syndrome of immune reconstitution, which does not meet the accepted criteria for assessing the effectiveness of treatment. Materials and methods. Dynamic monitoring of the results of treatment of a patient with tuberculosis combined with HIV infection. Research methods: clinical, radiological, laboratory and microbiological. Results and its discussion. In a patient with tuberculosis combined with HIV infection, a paradoxically high increase in the number of CD4 lymphocytes (15 times) is possible with inflammatory syndrome of immune restoration, followed by a sharp decrease. Conclusion. Approaches to developing criteria for assessing the effectiveness of treatment for patients with tuberculosis combined with HIV infection require further research and additional recommendations.