Background: A 38-year-old man, without significant medical history, was referred to the hospital with weight loss, fatigue, night sweat, non-productive coughing and aphthae in the mouth. Physical examination displayed a cachectic man with small lymph nodes palpable in the supraclavicular region. Auscultation of heart, lungs and abdomen displayed no abnormalities. Blood examination revealed Hb of 5.4 mmol/l, erythrocyte sedimentation rate of 107 mm/h and leukocyte count of 6.0 x 109/l. Additional blood examination showed a IgA of 4.2 g/l and revealed that the patient was HIV-1 positive, but seronegative for hepatitis B, hepatitis C, lues and tuberculosis.