Alopecia Universalis and Graves’ Disease in the Setting of Immune Restoration After Highly Active Antiretroviral Therapy

The document reported a case of a 30-year-old HIV-infected man who developed alopecia universalis and Graves' disease following immune restoration after starting highly active antiretroviral therapy (HAART). Initially, the patient showed a significant increase in CD4 cell count and suppression of viral load after HAART initiation. However, he experienced total body hair loss and was diagnosed with alopecia universalis, followed by the onset of Graves' disease. The case highlighted that immune reconstitution in AIDS patients on HAART could lead to autoimmune manifestations, possibly due to unbalanced regrowth of autoreactive and immunoregulatory components during intense immune repopulation. This case was notable as alopecia universalis had not been previously reported in HIV patients post-HAART initiation or in association with thyroid disease.