Hypersensitivity reactions and allergic manifestations of human immunodeficiency virus (HIV) infection have been observed since the beginning of the acquired immunodeficiency disease syndrome (AIDS) epidemic. Drug hypersensitivity remains the most visible and frequent untoward reaction, but chronic nasal symptoms and pruritic cutaneous disorders are also commonly observed allergic manifestations of HIV infection (1–3). Furthermore, a number of immunological derangements have been identified, which suggest an association between HIV infection and atopy. In this article, we review proposed pathophysiological mechanisms, diagnosis and management of the different clinical allergic disorders affecting HIV patients, and discuss controversial issues regarding immunotherapy in HIV disease.