title: Use of etanercept to treat rheumatoid arthritis in an HIV-positive patient: a case-based review.
abstract: Rheumatoid arthritis (RA) is a relatively common autoimmune disease that is associated with progressive disability and systemic complications, with a relatively high socioeconomic burden. The treatment of RA has been revolutionized by the use of biological drugs, such as anti-tumor necrosis factor (TNF) agents. A wide spectrum of RA disease severity has been reported among patients with human immunodeficiency virus (HIV) infection. Yet, only a few cases using anti-TNF therapy have been described in this clinical population. Therefore, the aim of our case-based review was to describe the successful use of etanercept in a 38-year-old female patient with RA concomitant with HIV infection, who had been resistant to the first-line anti-rheumatic therapies. As per routine care guidelines, the patient was screened for hepatitis virus infection, latent tuberculosis, and other infectious conditions, prior to the initiation of etanercept treatment. CD4 cell count, HIV viral load, and adverse effects were closely monitored during the treatment. The HIV infection remained stable with etanercept treatment, without the need for anti-retrovirus agents. No adverse effects and serious infections were identified during the treatment. Therefore, anti-TNF therapy is a viable alternative for the treatment of RA in patients with HIV, who do not respond to conventional anti-rheumatic therapies. The relationship between TNF-α and HIV infection, as well as cautionary guidelines regarding the utilization of anti-TNF therapy in this clinical population, is discussed.
authors.affiliation: Division of Rheumatology, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
authors.forename: Shen-Ju
authors.initials: SJ
authors.lastname: Liang
authors.affiliation: Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Quan-You
authors.initials: QY
authors.lastname: Zheng
authors.affiliation: Division of Rheumatology, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
authors.forename: Yan-Long
authors.initials: YL
authors.lastname: Yang
authors.affiliation: Division of Rheumatology, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Division of Rheumatology, Daping Hospital, Third Military Medical University, Chongqing, 400042, China. dpyylcy2004@163.com.
authors.forename: Chong-Yang
authors.initials: CY
authors.lastname: Liu
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D018791:CD4 Lymphocyte Count; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D006801:Humans; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology; D019562:Viral Load
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept
keywords: Anti-TNF-α therapy; Etanercept; Human immunodeficiency virus infection; Rheumatoid arthritis