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Editor,—A 37 year old Portuguese man presented to the genitourinary (GU) medicine department with constitutional symptoms. He had a history of injecting drug use and had been identified as positive for the human immunodeficiency virus (HIV) antibody in Portugal 5 years previously. He had not been in contact with medical services for a year. Confirmatory HIV antibody testing was positive. The CD4 lymphocyte count was 50 × 106/l and the viral load below the limit of detection (<40–80 copies/ml). He was admitted for …