HIV infection is associated with a less aggressive phenotype of inflammatory bowel disease. A multicenter study of the ENEIDA registry.

Autores de IIS La Fe

• Marisa Iborra Colomino

  Autor

Participantes ajenos a IIS La Fe

• Calafat M
• Suria C
• Mesonero F
• de Francisco R
• Caballero CY
• Peña L
• Hernández-Camba A
• Marcé A
• Gallego B
• Martín-Vicente N
• Rivero M
• Guerra I
• Carrillo-Palau M
• Madero L
• Burgueño B
• Monfort D
• Torres G
• Teller M
• Ferrer Rosique JÁ
• Villaamil PV
• Roig C
• Ponferrada-Diaz A
• Glaría EB
• Zabana Y
• Gisbert JP
• Busquets D
• Alcaide N
• Camps B
• Legido J
• González-Vivo M
• Bosca-Watts MM
• Pérez-Martínez I
• Deza DC
• Guardiola J
• Hernández LA
• Navarro M
• Gargallo-Puyuelo CJ
• Cañete F
• Mañosa M
• Domènech E
• ENEIDA registry of GETECCU

Grupos

• Enfermedad Inflamatoria Intestinal

Abstract

BACKGROUND: The coexistence of human immunodeficiency virus (HIV) infection and inflammatory bowel disease (IBD) is uncommon. Data on the impact of HIV on IBD course and its management is scarce. AIM: To describe the IBD phenotype, therapeutic requirements and prevalence of opportunistic infections (OI) in IBD patients with a coexistent HIV infection. METHODS: Case-control, retrospective study including all HIV positive patients diagnosed with IBD in the ENEIDA registry. Patients with positive HIV serology (HIV-IBD) were compared to controls (HIV seronegative), matched 1:3 by year of IBD diagnosis, age, gender and type of IBD. RESULTS: A total of 364 patients (91 HIV-IBD and 273 IBD controls) were included. In the whole cohort, 58% had ulcerative colitis (UC), 35% had Crohn's disease (CD) and 7% were IBD unclassified. The HIV-IBD group presented a significantly higher proportion of proctitis in UC and colonic location in CD but fewer extraintestinal manifestations than controls. Regarding treatments, non-biological therapies (37.4% vs. 57.9%; P=0.001) and biologicals (26.4% vs. 42.1%; P=0.007), were used less frequently among patients in the HIV-IBD group. Conversely, HIV-IBD patients developed more OI than controls regardless of non-biological therapies use. In the multivariate analysis, HIV infection (OR 4.765, 95%CI 2.48-9.14; P<0.001) and having =1 comorbidity (OR 2.445, 95%CI 1.23-4.85; P=0.010) were risk factors for developing OI, while CD was protective (OR 0.372, 95%CI 0.18-0.78;P=0.009). CONCLUSIONS: HIV infection appears to be associated with a less aggressive phenotype of IBD and a lesser use of non-biological therapies and biologicals but entails a greater risk of developing OI.

Copyright © 2024 by The American College of Gastroenterology.

Keywords

• inflammatory bowel disease; human immunodeficiency virus; immunosuppression; opportunistic infections; ENEIDA