[Association of systemic lupus and HIV/AIDS: nine observations at the Centre Hospitalier Universitaire de Libreville (Gabon)].

Abstract

Background: HIV/AIDS infection is endemic in sub-Saharan Africa. It is manifested by a variety of opportunistic diseases that usually occur when the CD4 count is below 200/mm³, but also during the immune restoration syndrome (IRS) that occurs under highly active antiretroviral therapy (HAART). Autoimmune and inflammatory diseases are rarely associated with this condition. We report nine Gabonese cases of systemic lupus associated with HIV.

Material and methods: This was a retrospective, descriptive and analytical study conducted from 1 June 2016 to 30 April 2024 at the Department of Internal Medicine of the CHU of Libreville. All patients with this association were identified to specify the different characteristics.

Results: Nine female patients with an average age of 36 years were identified. Systemic lupus was associated with the diagnosis of HIV1 disease (n = 1) or occurred after the initiation of antiretroviral treatment (n = 6) or a new line of antiretroviral treatment (n = 2), with a mean CD4 count at diagnosis of 284.5/mm³, rising to 578.3/mm³.

Discussion and conclusion: There is a structural similarity at the origin of autoantibody production in HIV1 and systemic lupus, with clinical, biological and immunological signs that are sometimes superimposed, which may make the diagnosis of this association difficult.