Successful Biological Treatment of a Patient With Psoriasis and HIV

Abstract

The use of biological agents for the management of chronic dermatological pathologies such as psoriasis is becoming more common every day. Until now, antibodies against tumor necrosis factors (TNF-α) inhibitors, interleukin IL-17 inhibitors, IL-12/23 inhibitors, and IL-23 inhibitors have been marketed as biological therapies for psoriasis, showing excellent results with a minimal number of adverse events. Initially, the first biological treatments were associated primarily with opportunistic infections. Later, specific adverse events were described depending on the biological agent used: TNF-α inhibitors were linked to tuberculosis, while anti-IL-17 agents were associated with candidiasis and worsening of inflammatory bowel disease (IBD). However, such therapies warrant a cautious screening protocol to detect pre-existing infections, mainly tuberculosis and chronic viral infections such as hepatitis. Human immunodeficiency virus (HIV) is only screened in case of suspicion and in some institutional protocols. We present the clinical case of a person living with HIV under optimal virological control, in which the use of biological therapy was imperative to control psoriasis and he also presented with great severity. Until now there is no official statement on the use or not of biologicals in this particular population.