Emergence of manifestations of HIV infection in a case of systemic lupus erythematosus following treatment with IV cyclophosphamide.
Systemic lupus erythematosus (SLE) and infection with human immunodeficiency virus are rarely seen in the same patient. We describe a case of a 32-year-old lady, who was diagnosed with systemic lupus erythematosus (anti-dsDNA antibody positive) and was initially serologically negative for human immunodeficiency virus (HIV) infection. Following three cycles of IV cyclophosphamide, she was subsequently found to be infected with HIV, with marked depletion of peripheral CD4-positive T lymphocytes. While her SLE remained completely inactive, the course of HIV was rapidly progressive, suggesting that retroviral replication may have been enhanced by the underlying immunomodulation caused by cyclophosphamide and also by SLE per se.
Hazarika
Indrajit
I
Department of Medicine, Gauhati Medical College Hospital, Guwahati-32, Assam, India. indrajit25@yahoo.com
Chakravarty
Bhabani Prasad
BP
Dutta
Sangit
S
Mahanta
Neelakshi
N
D000328:Adult; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007275:Injections, Intravenous; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide