Tuberculous Pericarditis in a Woman Infected With Human Immunodeficiency Virus Type 1, Long-term Nonprogressive

Abstract

We read with interest the recent article in theArchivesby Graham et al¹regarding the effect of isoniazid chemoprophylaxis on patients infected with human immunodeficiency virus (HIV). Their results showed a significant decrease in the incidence of mycobacterial disease in patients who were treated with isoniazid at various dosages during a 12-month period. However, it is not clear what happened when the secondary prophylaxis was stopped. In this regard, some reports²have recommended lifelong isoniazid chemoprophylaxis, whereas others³argue against it. We present a case that illustrates that a 12-month regimen may not be enough for all patients. Human immunodeficiency virus type 1 (HIV-1) infection, acquired by heterosexual transmission, was diagnosed in a 32-year-old woman in 1986. Since then, her blood lymphocyte CD4 cell count had been above 0.70×10⁹/L. The patient's condition was categorized as long-term and nonprogressive; therefore, she had never received antiretroviral