What is commonly observed in the peripheral blood smear of a patient with HIV infection?

In the context of a patient with HIV infection, the presence of reactive lymphocytes in a peripheral blood smear is a common finding. Reactive lymphocytes are typically larger than normal lymphocytes and may have more abundant cytoplasm. Their increase is often a result of the immune system responding to a viral infection, such as HIV. In HIV, the immune system is stimulated to produce these atypical lymphocytes as a response to the ongoing viral replication and immune activation.

This response is a part of the body’s effort to manage and control the infection. The appearance of these reactive lymphocytes indicates that the immune system is engaged, which is significant when monitoring an HIV-positive patient’s immune response and disease progression. While there may be other abnormal findings in the blood smear, the presence of reactive lymphocytes serves as a key indicator of the body's attempt to mount a defense in the setting of viral infections like HIV.