Regarding MIC, our experience with this patient does not correlate with the recently published guidelines [38] for the management of cryptococcal meningitis: in particular continuing fluconazole treatment and repeated brain biopsies were essential for management despite the CD4 count increasing above 100 cells/μL. Corticosteroids for IRIS caused substantial morbidity, but there is no established alternative and possible therapy with thalidomide would not have been safe in this patient of childbearing potential. This evidence concerns the gene CD4 and Cryptococcal meningitis.