Human immunodeficiency virus in a cohort of systemic lupus erythematosus patients

Vanessa Hax,Luciano Zubaran Goldani,Ricardo Machado Xavier,Ana Laura Didonet Moro,Odirlei Andre Monticielo,Rafaella Romeiro Piovesan

doi:10.1186/s42358-018-0003-2

Abstract

BackgroundSystemic lupus erythematosus (SLE) and acquired immunodeficiency syndrome (AIDS) share many clinical manifestations and laboratory findings, therefore, concomitant diagnosis of SLE and human immunodeficiency virus (HIV) can be challenging.MethodsProspective cohort with 602 patients with SLE who attended the Rheumatology Clinic of the Hospital de Clínicas de Porto Alegre since 2000. All patients were followed until 01 May 2015 or until death, if earlier. Demographic, clinical and laboratory data were prospectively collected.ResultsOut of the 602 patients, 11 presented with the diagnosis of AIDS (1.59%). The following variables were significantly more prevalent in patients with concomitant HIV and SLE: neuropsychiatric lupus (10.9% vs. 36.4%; p = 0.028) and smoking (37.6% vs. 80%; p = 0.0009) while malar rash was significantly less prevalent in this population (56% vs. 18.2%; p = 0.015). Nephritis (40.5% vs. 63.6%; p = 0.134) and hemolytic anemia (28.6% vs. 54.5%; p = 0.089) were more prevalent in SLE patients with HIV, but with no statistical significance compared with SLE patients without HIV. The SLICC damage index median in the last medical consultation was significantly higher in SLE patients with HIV (1 vs. 2; p = 0,047).ConclusionsOur patients with concomitant HIV and SLE have clinically more neuropsychiatric manifestations. For the first time, according to our knowledge, higher cumulative damage was described in lupus patients with concomitant HIV infection. Further studies are needed to elucidate this complex association, its outcomes, prognosis and which therapeutic approach it’s best for each case.

Highlights

Systemic lupus erythematosus (SLE) and acquired immunodeficiency syndrome (AIDS) share many clinical manifestations and laboratory findings, concomitant diagnosis of SLE and human immunodeficiency virus (HIV) can be challenging
Our study consisted of 602 SLE patients, 75.2% European derived, 92% female and 11 (1.59%) of these patients presented with HIV
The following features were more prevalent in SLE patients with HIV, but without to reach statistical significance compared with SLE patients without HIV: nephritis (40.5% vs. 63.6%; p = 0.134), hemolytic anemia (28.6% vs. 54.5%; p = 0.089), presence of anti-Ro (39.4% vs. 63.6%; p = 0.125) and anti-La (13.1% vs. 27.3%; p = 0.172), cardiovascular disease (18.1% vs. 36.4%; p = 0.126) and diabetes mellitus (7.7% vs. 18.2%; p = 0.212)

Summary

Introduction

Systemic lupus erythematosus (SLE) and acquired immunodeficiency syndrome (AIDS) share many clinical manifestations and laboratory findings, concomitant diagnosis of SLE and human immunodeficiency virus (HIV) can be challenging. SLE and human immunodeficiency virus (HIV) infection share many clinical manifestations, including musculoskeletal symptoms such as myalgia, arthralgia/arthritis, skin rashes, lymphadenopathy and organ involvement, such as kidneys, heart, lungs and central nervous system [1]. They have several common laboratory findings such as anemia, leukopenia, lymphopenia, thrombocytopenia and hypergammaglobulinemia [1]. The present study aimed to demonstrate the profile of these patients in our center, appointing their clinical and laboratory features, the significant differences between the patients with or without HIV, the treatment offered and their evolution considering infections, other diseases and mortality

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