Concomitant systemic lupus erythematosus and HIV infection

Liao, Hongyan; Tao, Chuanmin; Su, Jun

doi:10.1097/md.0000000000009337

Cited by 10 publications

(5 citation statements)

References 54 publications

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“…In 1993, Barthel et al stated that based on epidemiological data for HIV and SLE, the number of patients with complications should be as high as 400 in the United States alone [ 6 ]. To date, however, only about 80 cases of SLE and HIV have been reported worldwide, and the relationship between these diseases is unclear [ 7 , 8 ]. We consider that there are several possible reasons for the small number of reports.…”

Section: Discussionmentioning

confidence: 99%

Antiretroviral Therapy Improves Acquired Immunodeficiency Syndrome with Systemic Lupus Erythematosus

Okada¹,

Nozaki²,

Rai³

et al. 2021

Life

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A 35-year-old male was referred to our hospital with dysesthesia of the lower extremities that had begun six months earlier. A blood test revealed the presence of various antibodies, suggesting a collagen-related peripheral neuropathy. However, a history of repeated shingles and sex with males was noted, and the patient was tested for and diagnosed with human immunodeficiency virus (HIV) infection. Based on the manifestations and laboratory data, including the results of immunological and urinary tests, he was further diagnosed with concomitant systemic lupus erythematosus (SLE). The activity of SLE improved with antiretroviral therapy. There is currently no established treatment for AIDS complicated with SLE. Indeed, because HIV treatment involves the activation of immune function and SLE treatment involves immunosuppression, any treatments for the two conditions would be in conflict. It is thus necessary to select a treatment strategy based on the condition of the individual patient. In addition, because HIV infection is relatively rare in Japan compared to other countries, rheumatologists in Japan must keep HIV infection in mind as a differential diagnosis for autoimmune diseases.

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Section: Discussionmentioning

confidence: 99%

Antiretroviral Therapy Improves Acquired Immunodeficiency Syndrome with Systemic Lupus Erythematosus

Okada¹,

Nozaki²,

Rai³

et al. 2021

Life

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“…Administration of rituximab with a good clinical response has been seen in patients with both SLE and HIV previously. 8,9…”

Section: Discussionmentioning

confidence: 99%

HIV and systemic lupus erythematosus: where immunodeficiency meets autoimmunity

O’Kelly

McNally

McConkey

et al. 2020

Lupus

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We report a case of a new diagnosis of systemic lupus erythematosus (SLE) in a patient with HIV who presented to the outpatient department with a fever, headache and lymphadenopathy. Cerebrospinal fluid analysis showed lymphocytic pleocytosis. Initial concerns were for an infectious process, and investigations for systemic and central nervous system infection were negative. Serum testing for ANA, dsDNA, nucleosome, anti-histone and ribosomal-P antibodies was positive. A magnetic brain imaging scan of the brain showed a well-circumscribed lesion in the right cerebellar peduncle on T2/FLAIR. The patient was commenced on prednisolone and rituximab, and had a good clinical response. The cerebellar lesion resolved and has not recurred with sequential imaging. SLE and HIV are both multi-systemic diseases which rarely co-occur. Autoimmune processes should be considered in HIV patients with multi-systemic symptoms and signs.

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“…(5) According to the literature, there is a correlation between multiple autoimmune and non-autoimmune diseases with false positive results in ELISA tests due to the production of immunoglobulins that generate cross-reactions with antibodies against the HIV virus. (8)(9)(10)(11) According to Barthel & Wallace (11), the first reports of false positive results were described in the 1980s with studies by Perentice et al in 1985 and Calabrese et al in 1986, in which 41 SLE patients had HIV-positive ELISA test results. The researchers considered that this was caused by antibodies against altered H9 nuclear antigens.…”

Section: Discussionmentioning

confidence: 99%

False-positive fourth-generation HIV test associated with autoimmune hemolytic anemia. Case report

et al. 2019

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Introduction: The fourth-generation ELISA human immunodeficiency virus (HIV) screening test has a high sensitivity and specificity >99% to detect both antigens and antibodies. Estimates are that only 0.5% yield false positive results.Case description: 61-year-old female patient with a clinical picture consisting of malaise, unquantified fever, asthenia and adynamia. Laboratory tests revealed anemia, so a Coombs test was performed, obtaining a positive result along with other findings of mixed autoimmune hemolytic anemia. Two fourth-generation ELISA HIV screening tests were performed obtaining positive results. Given the national recommendations on the diagnosis of HIV infection, a viral load was performed, which turned out to be negative, so the result was considered a false positive.Discussion: Clinical and biological factors are related to false positive results. There are descriptions about autoimmunity phenomena, such as systemic lupus erythematosus or autoimmune hemolytic anemia, with few cases in older adults.Conclusions: Rapid tests have changed the diagnosis of HIV infection worldwide; however, like any other diagnostic test, they may yield false positive results with differential diagnoses, including autoimmune hemolytic anemia.

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Concomitant systemic lupus erythematosus and HIV infection

Cited by 10 publications

References 54 publications

Antiretroviral Therapy Improves Acquired Immunodeficiency Syndrome with Systemic Lupus Erythematosus

Antiretroviral Therapy Improves Acquired Immunodeficiency Syndrome with Systemic Lupus Erythematosus

HIV and systemic lupus erythematosus: where immunodeficiency meets autoimmunity

False-positive fourth-generation HIV test associated with autoimmune hemolytic anemia. Case report

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