title: Concomitant systemic lupus erythematosus and HIV: case series and literature review.
abstract: OBJECTIVE
  To determine the effect of systemic lupus erythematosus (SLE) and human immunodeficiency virus (HIV) infection on the course of each other and to review the published reports on concomitant SLE and HIV infection.
  
  
  METHODS
  We performed a retrospective review of the records of patients with SLE and HIV seen in the Department of Rheumatology at the Inkosi Albert Luthuli Central Hospital, Durban, South Africa. We used the terms "systemic lupus erythematosus" and "HIV" or "AIDS" to identify patients with SLE and HIV infection reported in the English medical literature.
  
  
  RESULTS
  We identified 13 patients with SLE and HIV infection. All the patients were females and there were 11 African blacks and 2 Indians. SLE and HIV infection were diagnosed together in 6 patients. In this group, there were 5 lupus flares in 4 patients, and 2 of the flares followed highly active anti-retroviral treatment (HAART). Five patients developed HIV after the diagnosis of SLE. The 3 patients in whom follow-up data was available had inactive SLE, one of whom was on HAART. Two HIV-positive patients developed SLE after receiving HAART for 30 and 35 mo. Seven of our patients also had tuberculosis. Our literature search identified 58 previously reported patients with HIV and SLE.
  
  
  CONCLUSIONS
  Our case series and review of the literature show that there is a reduction in SLE disease activity in patients with concomitant SLE and HIV. However, when lupus flares occur in HIV-positive patients, they are unrelated to the use of HAART.
authors.affiliation: Department of Rheumatology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Inkosi Albert Luthuli Central Hospital, Durban, South Africa. Electronic address: modyg@ukzn.ac.za.
authors.forename: Girish M
authors.initials: GM
authors.lastname: Mody
authors.affiliation: Department of Rheumatology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
authors.forename: Neeta
authors.initials: N
authors.lastname: Patel
authors.affiliation: Department of Rheumatology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
authors.forename: Amritha
authors.initials: A
authors.lastname: Budhoo
authors.affiliation: Department of Rheumatology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
authors.forename: Thozama
authors.initials: T
authors.lastname: Dubula
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013019:South Africa; D016896:Treatment Outcome; D055815:Young Adult
keywords: AIDS; Anti-retroviral therapy; HAART; HIV; Immune reconstitution inflammatory syndrome (IRIS); Systemic lupus erythematosus