In our cohort, more advanced immunosuppression manifested by lower CD4+ T-cell counts, higher HIV RNA levels, and lower CD4/CD8 ratio, in addition to higher mycobacterial antigen load suggested by extra-pulmonary TB foci, lower hemoglobin levels and shorter interval from ATT to ART were all associated with paradoxical TB-IRIS in an univariate statistical model. The gene discussed is CD8A; the disease is tuberculosis.