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Autoimmun Rev. 2014 Aug;13(8):850-7. doi: 10.1016/j.autrev.2014.04.005. Epub 2014 Apr 18.

Autoimmune diseases in HIV-infected patients: 52 cases and literature review.

Author information

1
Internal Medicine Department, Jean Verdier Hospital, Avenue du 14 Juillet, 93140 Bondy, France. Electronic address: laura.iordache@sls.aphp.fr.
2
Clinical Investigation Centre, Cochin Hospital, 27 rue du Fbg St.-Jacques, 75014 Paris, France.
3
Infectious Diseases Department, Avicenne Hospital, 125 rue de Stalingrad, 93009 Bobigny, France.
4
Infectious Diseases Department, Jean Verdier Hospital, Avenue du 14 Juillet, 93140 Bondy, France.
5
Internal Medicine Department, Kremlin Bicetre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicetre, France.
6
Internal Medicine Department, Antoine Béclère Hospital, 157 rue de la Porte de Trivaux, 92140 Clamart, France.
7
Internal Medicine and Clinical Immunology Department, Pitié-Salpétrière Hospital, 47-83 bd de l'Hopital, 75013 Paris, France; Hospital-University Department I2B, Sorbonne Universités, UPMC Paris 6 University, UMR 7211, F-75005, Paris, France; INSERM, UMR S959, F-75013, Paris, France; CNRS, UMR 7211, F-75005, Paris, France.
8
Internal Medicine Department, Ambroise Paré Hospital, 9 Avenue Charles-de-Gaulle, 92100 Boulogne Billancourt, France.
9
Internal Medicine Department, St. Louis Hospital, 1 Avenue Claude-Vellefaux, 75010 Paris, France.
10
Internal Medicine Department, Jean Verdier Hospital, Avenue du 14 Juillet, 93140 Bondy, France.

Abstract

OBJECTIVES:

1) To describe autoimmune diseases (AD) in HIV-infected people; and 2) to perform a literature review concerning this issue.

DESIGN:

52 HIV-infected patients that presented an AD in 14 medical departments in Paris and Ile-de-France area were retrospectively included in this study.

RESULTS:

The ADs were vasculitis (11), immune cytopenias (8), rheumatic diseases (8), lupus (7), sarcoidosis (7), thyroid diseases (6), hepatic diseases (5), and antiphospholipid syndrome (4). Four patients presented 2 ADs. In 5 patients the AD preceded HIV infection, in 14 HIV infection was diagnosed at the same time as the AD and 34 were HIV-infected when they developed an AD. 40 ADs (80%) occurred in patients with a CD4 T lymphocyte count of more than 200/mm(3). Cases of autoimmune hemolytic anemia occurred only in patients severely immunodepressed. In five patients (a vasculitis case, a sarcoidosis case, three thyroid disease cases) the AD presented as a form of immune restoration inflammatory syndrome (IRIS). Some ADs allowed HIV-infection diagnosis at a stage of moderate immune deficiency (vasculitis, antiphospholipid syndrome, immune thrombocytopenia). 37 patients received immunosuppressant treatments with good tolerance. These results confirm in a large series of patients previous data concerning autoimmune diseases occurrence in HIV-infected people.

CONCLUSION:

In the HAART era, when HIV-infected people are treated more and more early, autoimmune diseases can occur, mainly at the phase of immunological recovery. HIV infection should not limit immunosuppressant treatment use.

KEYWORDS:

Autoimmunity; HIV; Immunosuppressant drugs

PMID:
24747058
DOI:
10.1016/j.autrev.2014.04.005
[Indexed for MEDLINE]

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