Several cases of paradoxical immune reconstitution inflammatory syndrome (IRIS) have been reported, predominantly presenting as T1R within six months of ART initiation, especially in borderline tuberculoid leprosy [37,38], principally manifesting as leprosy T1R after improved cell-mediated immunity due to increasing the CD4+ T lymphocyte count, usually within the first six months of antiretroviral therapy, mostly in borderline forms, predominantly the borderline tuberculoid form [39]. Here, CD4 is linked to leprosy.