Extreme symptoms (dysphagia and profound weight loss), signs (cachexia evidenced by extreme weight loss, very low BMI, and temporal and intercostal muscle wasting), endoscopic findings (massive cheesy esophageal mucosal exudate), radiologic findings (deep ulcers mimicking pseudo-diverticula), pathologic findings, and recurrence of both infections after 12 years are all attributed to profound immunocompromise (last CD4 cell count = 4 mil/L) from poor adherence to antiretroviral therapy. This evidence concerns the gene CD4 and Cachexia.