Clinical and therapeutic implications in HIV-systemic lupus erythematosus coinfection

Abstract

HIV and systemic lupus erythematosus (SLE) coinfection has posed a significant clinical challenge due to the interaction between both pathologies and their treatments. It has been observed that antiretroviral therapy in these cases could induce immune reconstitution inflammatory syndrome (IRIS), exacerbating lupus activity. Therefore, this study analyzed, based on a clinical case, the relationship between HIV infection and the development of systemic lupus erythematosus by evaluating clinical manifestations, disease activity, and complications such as hepatotoxicity. The Saaty AHP method was applied to identify critical factors in therapeutic management, as well as the clinical manifestations found in the reviewed literature. The results showed an exacerbation of systemic lupus erythematosus after antiretroviral therapy and significant hepatotoxicity, partially resolved with treatment adjustments. However, the pathogenic relationship between HIV and autoimmune diseases remains uncertain, complicating early diagnosis and personalized management for optimizing long-term clinical outcomes. Furthermore, balanced management of immunosuppression and infection prevention were identified as key factors. In conclusion, the integration of multidisciplinary areas has been suggested to optimize the diagnosis, treatment, and prognosis of these complex cases. Additionally, the development of research projects to promote the creation of clinical protocols for the multidisciplinary management of patients with HIV and autoimmune diseases has been recommended.