A 39-year-old cisgender man with HIV began treatment for severe disseminated histoplasmosis 15 months ago. After 2 weeks of induction therapy with intravenous liposomal amphotericin B, he started maintenance therapy with oral itraconazole (200 mg three times a day for 3 days, then 200 mg twice daily). After 1 year, the itraconazole dose was reduced to 200 mg once daily as long-term suppressive therapy. He has received antiretroviral therapy for 14 months with persistently undetectable HIV RNA levels. After 6 months of antiretroviral therapy, the CD4 count increased from a nadir of 28 cells/mm³ to 225 cells/mm³. Recent laboratory studies show a CD4 count of 276 cells/mm³, negative fungal blood cultures, and negative serum Histoplasma antigen.