Stavudine‐Induced Macrocytosis During Therapy for Human Immunodeficiency Virus Infection

younger than 20 years of age in a large series [4]) and is more commonly described in individuals of Asian ethnicity. Aneurysm formation occurs in 15%–30% of patients with TA, particularly children [4]. The cause of TA is unknown, although an autoimmune process has been postulated. There were early reports of Mycobacterium tuberculosis infection in association with TA in areas where tuberculosis is highly endemic, but a direct causal relationship has not been demonstrated [5]. No cases of concurrent TA and HIV infection were found in a review of the world literature despite these diseases having similar geographic distributions and age incidences in Asia. No direct causal relationship could be demonstrated between HIV infection, suspected tuberculous infection, and large vessel arteritis in this case, and the patient’s ethnicity and geographic location may make this a chance occurrence. However, the possible autoimmune nature of TA and the observed frequency of autoimmune phenomena in HIV infection should make this combination more likely, especially in children. We propose that large vessel arteritides such as TA should be considered in HIV-infected individuals, including children, who present with persistent fever when an initial workup has been nondiagnostic.