Anemia, wasting syndrome, and tattooing: A clinical triad to suspect HIV in the community.

Anemia, wasting syndrome, and a history of tattooing form a rare and concerning triad observed in cases of human immunodeficiency virus (HIV) infection. Although the overall prevalence of HIV/acquired immunodeficiency syndrome (AIDS) has decreased globally, there is an alarming rise in the risk of transmission linked to unregulated or unlicensed tattooing practices. In this case report, we present the medical history of a man in his 30s, who recently tested positive for HIV-1 antibodies. Upon presentation, he exhibited multiple concerning symptoms, including watery diarrhea, fever, and a significant weight loss of over 6 months. Additionally, he suffered from acute kidney injury, which further complicated his clinical picture. Comprehensive laboratory evaluations indicated dangerously low CD4 counts at 71/μL and a remarkably high HIV viral load, alongside severe anemia. The diagnosis of autoimmune hemolytic anemia (AIHA) was confirmed through several laboratory tests that demonstrated hemolysis, reticulocytosis, and a positive direct antiglobulin test. His treatment regimen included co-trimoxazole and nitazoxanide to manage his diarrhea, coupled with antiretroviral therapy specifically aimed at treating HIV/AIDS Stage three. Furthermore, prednisolone was prescribed to address the AIHA. Due to the critically declining hemoglobin levels, the patient required multiple blood transfusions to stabilize his condition. This case emphasizes the urgent need for stricter regulations surrounding tattooing practices, ensuring that proper hygiene standards and sterile equipment are upheld, particularly in developing regions where such infectious risks are heightened. The presence of this triad of symptoms should prompt healthcare professionals to maintain a high index of suspicion for HIV infection in similar patients, ultimately leading to earlier intervention and treatment.