We read with interest the recent article in the Archives by Graham et al1 regarding 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 reports2 have recommended lifelong isoniazid chemoprophylaxis, whereas others3 argue 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