Different studies identified that age <35 years, being male, higher educational level, urban residence, unemployment, advanced clinical stage III/IV, having history of TB co-infection, baseline CD4< 100cell/mm3, baseline BMI <18.5 kg/mm2, poor adherence, lost to follow up, baseline ART regimen, high frequency of alcohol use and smoking as determinant factors of first-line antiretroviral treatment failure [14–18]. The gene discussed is CD4; the disease is tuberculosis.