Journal Article

Impact and Tolerance of Immunosuppressive Treatments in Patients Living with HIV with Inflammatory or Autoimmune Diseases

Robineau, Olivier, Fontier, Clotilde, Bazus, Hélène, Deconinck, Laurène, Bataille, Pierre, Meybeck, Agnès, Cheret, Antoine, Viget, Nathalie, Surgers, Laure, Guitton, Zélie

2022

Overview

Background: Patients living with HIV (PLWHIV) can develop autoimmune diseases (AD) needing immunosuppressive treatments (IST). This study aims to describe the impact of IST in PLWHIV. Methods: This was a multicentric retrospective observational study in six HIV referral centers on PLWHIV under IST for AD. Demographic factors, viral co-infections, immunovirological status before and under IST, infectious events, and their descriptions were collected and described focusing on infectious events, immunovirological variations, and IST effectiveness. Results: 9480 PLWHIV were screened for inclusion. Among them, 138 (1.5%) had a history of auto-immune disease, among which 32 (23%) received IST. There was mainly spondyloarthropathy (28%) and the most commonly used IST was methotrexate. The median follow-up under IST was 3.8 years (2.7; 5.9). There were 15 infectious events (0.5 events/individuals) concerning nine patients. At the last medical follow-up, 81% of these were in remission of their AD. Under IST, there was an increase in CD4 during follow-up (629 vs. 827 CD4/mm3, p = 0.04). No HIV virological failure was noted. Conclusions: This study supports a growing evidence base that IST can be used safely and effectively in PLWHIV with careful monitoring.

• Publisher: MDPI AG,MDPI
• Subject: anti-TNFα / auto-immune disorder / Autoimmune diseases / Biological products / Care and treatment / Case reports / CD4 antigen / Chronic obstructive pulmonary disease / Diabetes / Dosage and administration / Drug therapy / Evolution / Hepatitis / HIV / HIV patients / Human immunodeficiency virus / Immunological diseases / Immunological tolerance / Immunosuppressive agents / immunosuppressive treatment / Infections / Inflammatory bowel disease / inflammatory diseases / Life Sciences / Lupus / Medical records / Methotrexate / Observational studies / Patient outcomes / Patients / Population / Psoriasis / Remission / Remission (Medicine) / Rheumatoid arthritis / Spondyloarthropathy / Steroids / Tuberculosis / Tumor necrosis factor-TNF