Bio's for psoriasis in HIV patients

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This study looked at the effect of biologic therapy in HIV patients with psoriasis.

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Background:
Psoriasis is a chronic immune mediated inflammatory disorder which also occurs in the setting of HIV. Biologic therapy has transformed the treatment landscape for psoriasis however individuals with HIV are excluded from clinical trials. The impact of biologic therapy upon blood parameters in HIV is unclear and only observed in small case series.

Objective:
To assess the effect of biologic therapy in psoriasis vulgaris in individuals with well controlled HIV, upon CD4+ cell counts, CD4+ proportion and HIV Viral load over 12 months.

Methods:
This retrospective cohort study was conducted at a tertiary referral centre in Sydney, Australia and included 36 HIV-positive individuals with psoriasis treated with biologic therapy, compared to 144 age, gender and HAART-matched individuals without psoriasis seen between 2010-2022. Outcomes of interest included HIV Viral Load, CD4+ cell count and incidence of infections.

Results:
No statistically significant difference was seen in baseline HIV Viral load and CD4+ count between individuals with psoriasis and without psoriasis. No significant change in CD4+ count or HIV Viral load was seen over the 12-month period of analysis in the HIV cohort without psoriasis. The HIV cohort treated with biologic therapy for psoriasis also did not demonstrate any significant change in HIV Viral load and CD4+ counts over the 12-month period examined. Stratification by type of biologic therapy used did not identify any significant changes in these parameters. Rates of infections and adverse events were also not significantly different between cohorts. It is possible that minor blips seen in the biologics cohort may be a risk factor for future virological failure, and future prospective longitudinal studies are required.

Conclusions:
In individuals with well controlled HIV, the use of biologic therapy for psoriasis does not significantly impact HIV Viral load, CD4+ cell count, CD4+ proportion and rates of infection over the first 12 months of therapy.

Source: onlinelibrary.wiley.com

*Early view funding unknown.