title: Autoimmune diseases in HIV-infected patients: 52 cases and literature review.
abstract: OBJECTIVE
  1) To describe autoimmune diseases (AD) in HIV-infected people; and 2) to perform a literature review concerning this issue.
  
  
  METHODS
  52 HIV-infected patients that presented an AD in 14 medical departments in Paris and Ile-de-France area were retrospectively included in this study.
  
  
  RESULTS
  The ADs were vasculitis (11), immune cytopenias (8), rheumatic diseases (8), lupus (7), sarcoidosis (7), thyroid diseases (6), hepatic diseases (5), and antiphospholipid syndrome (4). Four patients presented 2 ADs. In 5 patients the AD preceded HIV infection, in 14 HIV infection was diagnosed at the same time as the AD and 34 were HIV-infected when they developed an AD. 40 ADs (80%) occurred in patients with a CD4 T lymphocyte count of more than 200/mm(3). Cases of autoimmune hemolytic anemia occurred only in patients severely immunodepressed. In five patients (a vasculitis case, a sarcoidosis case, three thyroid disease cases) the AD presented as a form of immune restoration inflammatory syndrome (IRIS). Some ADs allowed HIV-infection diagnosis at a stage of moderate immune deficiency (vasculitis, antiphospholipid syndrome, immune thrombocytopenia). 37 patients received immunosuppressant treatments with good tolerance. These results confirm in a large series of patients previous data concerning autoimmune diseases occurrence in HIV-infected people.
  
  
  CONCLUSIONS
  In the HAART era, when HIV-infected people are treated more and more early, autoimmune diseases can occur, mainly at the phase of immunological recovery. HIV infection should not limit immunosuppressant treatment use.
authors.affiliation: Internal Medicine Department, Jean Verdier Hospital, Avenue du 14 Juillet, 93140 Bondy, France. Electronic address: laura.iordache@sls.aphp.fr.
authors.forename: Laura
authors.initials: L
authors.lastname: Iordache
authors.affiliation: Clinical Investigation Centre, Cochin Hospital, 27 rue du Fbg St.-Jacques, 75014 Paris, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Launay
authors.affiliation: Infectious Diseases Department, Avicenne Hospital, 125 rue de Stalingrad, 93009 Bobigny, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bouchaud
authors.affiliation: Infectious Diseases Department, Jean Verdier Hospital, Avenue du 14 Juillet, 93140 Bondy, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Jeantils
authors.affiliation: Internal Medicine Department, Kremlin Bicetre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicetre, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Goujard
authors.affiliation: Internal Medicine Department, Antoine Béclère Hospital, 157 rue de la Porte de Trivaux, 92140 Clamart, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Boue
authors.affiliation: Internal Medicine and Clinical Immunology Department, Pitié-Salpétrière Hospital, 47-83 bd de l'Hopital, 75013 Paris, France; Hospital-University Department I2B, Sorbonne Universités, UPMC Paris 6 University, UMR 7211, F-75005, Paris, France; INSERM, UMR S959, F-75013, Paris, France; CNRS, UMR 7211, F-75005, Paris, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.affiliation: Internal Medicine Department, Ambroise Paré Hospital, 9 Avenue Charles-de-Gaulle, 92100 Boulogne Billancourt, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hanslik
authors.affiliation: Internal Medicine Department, St. Louis Hospital, 1 Avenue Claude-Vellefaux, 75010 Paris, France.
authors.forename: Alfred
authors.initials: A
authors.lastname: Mahr
authors.affiliation: Internal Medicine Department, Kremlin Bicetre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicetre, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lambotte
authors.affiliation: Internal Medicine Department, Jean Verdier Hospital, Avenue du 14 Juillet, 93140 Bondy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Fain
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D005500:Follow-Up Studies; D005602:France; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance
keywords: Autoimmunity; HIV; Immunosuppressant drugs