Some patients initiating ART experience unique symptoms during immune system recovery. In these patients, clinical deterioration occurs despite increased CD4 + Tlymphocyte counts and decreased plasma HIV-1 viral loads [4] . This clinical deterioration is a result of an inflammatory response or "dysregulation" of the immune system to both intact subclinical pathogens and residual antigens [5] [6] [7] [8] [9] . Resulting clinical manifestations of this syndrome are diverse and depend on the infectious or noninfectious agent involved. These manifestations include mycobacterial-induced lymphadenitis [5] , paradoxical tuberculosis reactions [6, 7, 10, 11] , worsening of progressive multifocal leukoencephalopathy (PML) [12] , recurrence of cryptococcosis and Pneumocystis jirovecii pneumonia (PCP) [8, [13] [14] [15] [16] , Cytomegalovirus (CMV) retinitis [17] , shingles [18] , and viral hepatitis [19] , as well as noninfectious phenomena [20] .