ABSTRACT
Recently, paradoxical reactions have been reported with the concurrent administration of antiretroviral and antituberculosis therapy. These reactions are attributed to recovery of the patient’s delayed hypersensitivity response and include hectic fevers, lymphadenopathy, worsening of chest radiographic manifestations of tuberculosis (eg, miliary infiltrates, pleural effusions), and worsening of original tuberculous lesions (expanding central nervous system lesions). Changes in antituberculosis or antiretroviral therapy are rarely needed. If the symptoms are severe, a short course of steroids to suppress the enhanced immune response can be attempted while continuing with antituberculous and antiretroviral therapy.
