Hemophagocytic lymphohistiocytosis in a HIV positive patient associated with Pneumocystis Jirovecii pneumonia and hepatitis C infection

Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening syndrome of excessive immune activation with a high mortality rate. According to the literature, HLH in Human Immunodeficiency Virus (HIV) infected patients has not been reported in Sri Lanka. In HIV positive patients, HLH can be triggered either due to HIV per say or due to opportunistic infections (OI) or due to immune reconstitution inflammatory syndrome following initiation of ART. Here, we discuss a HIV positive patient who is having HLH with Pneumocystis jirovecii pneumonia (PJP) and hepatitis C infections. Our aim is to emphasize the importance of considering possible HLH in patients with HIV.