A major complication of HIV disease is worsening respiratory conditions, which are often of allergic origin. This is a pilot study to identify prevalence of IgE-mediated respiratory correlated with HIV seroconversion and disease progression, and to test the safety of a standard allergen immunotherapy regimen in these HIV+ patients. Four patients have been enrolled in the study, and one has completed the study. These subjects have a history of severe perennial allergic rhinitis poorly responsive to medical therapy. They started weekly AIT and were monitored for CD4 populations, viral load and in vitro cytokine production. Results showed CD4 counts remained stable and plasma viral load remained undetectable. The in vitro tetanus-induced IFNg levels increased while IL-4 and IL-10 levels remained relatively unchanged. Clinical response has been remarkable, with symptom scores demising and need for regular medications no longer necessary. These data suggest that AIT may have utility in selected HIV+ patients and support the need for a larger controlled trial to establish which HIV+ patients might be expected to benefit from this therapy.