2020
DOI: 10.1177/2475530320954279
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Biologic Treatment of 4 HIV-Positive Patients: A Case Series and Literature Review

Abstract: Background: The management of psoriatic disease in HIV-positive patients is challenging. Psoriasis in HIV-positive patients is often severe, progressive, and resistant to first- and second-line therapies, including topical treatments, phototherapy, highly active antiretroviral therapy (HAART), and oral retinoids. Other systemic agents used to treat psoriasis, such as methotrexate and cyclosporine, are immunosuppressants and thus many dermatologists may not feel comfortable prescribing them to HIV-positive pati… Show more

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Cited by 20 publications
(18 citation statements)
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“…13 In recent years, multiple case reports have demonstrated the safety of TNF-α antagonists in treating patients with HIV without increasing morbidity and mortality. [14][15][16] TNF-α increases HIV expression via nuclear factor (NF)-κB. Therefore, when the TNF-α level is elevated, HIV viral load is increased, and the CD4 + T lymphocyte count is decreased, leading to HIV progression.…”
Section: Discussionmentioning
confidence: 99%
“…13 In recent years, multiple case reports have demonstrated the safety of TNF-α antagonists in treating patients with HIV without increasing morbidity and mortality. [14][15][16] TNF-α increases HIV expression via nuclear factor (NF)-κB. Therefore, when the TNF-α level is elevated, HIV viral load is increased, and the CD4 + T lymphocyte count is decreased, leading to HIV progression.…”
Section: Discussionmentioning
confidence: 99%
“…[11][12][13][14][15] In psoriatic disease, the inflammatory response is also mediated by TNF-α and other cytokines that are responsible for stimulating angiogenesis and proliferation of keratinocytes that contribute to the psoriatic plaque development. 16 There are many case reports that demonstrate the safety profile and potential beneficial effect of TNF-α inhibitor use in HIV-positive patients 17 : 31 cases of etanercept, 11 cases of adalimumab, and 5 cases of infliximab. One patient treated with etanercept showed marked improvement of cutaneous and articular involvement of psoriasis, and the CD4 count and viral load remained stable during the course of the treatment.…”
Section: Patients With Human Immunodeficiency Virusmentioning
confidence: 99%
“…There are 16 case reports that show successful treatment of psoriasis in patients with HIV infections with ustekinumab without subsequent complication. 17 In one case, a patient with HIV, HBV, and psoriasis was maintained on ustekinumab for 4 years without worsening of his cutaneous or HIV-associated conditions. 24 Currently, there are only a small number of reports of use of an IL-17 inhibitor [25][26][27] or IL-23 inhibitor 28 in treating HIVpositive patients with psoriasis.…”
Section: Patients With Human Immunodeficiency Virusmentioning
confidence: 99%
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“…In these published cases, neither frequent infections nor worsening of HIV was reported. 1 Recently, a case series of two HIV positive patients with erythrodermic psoriasis treated succesfully with anti-IL-17 ihibitors (ixekizumab, secukinumab) was published. 5 According to a literature search, only one patient with HIV infection treated with the IL-23 inhibitor guselkumab and none treated with risankizumab have been reported to date.…”
mentioning
confidence: 99%