HIV infection may take the edge off inflammatory bowel disease

The course of inflammatory bowel disease (IBD) appears to be similar in patients with and without HIV infection, even though infected patients receive less treatments, according to a study.

A total of 195 IBD patients participated in the multicentre retrospective cohort study. Of these, 65 had HIV infection and 130 were uninfected. In the infected group, 22 patients (33.8 percent) required immunosuppressants and 31 (47.7 percent) received biologics.

Between the two patient groups, those with HIV infection had a significantly lower need for immunosuppressants (p=0.034 for Crohn’s disease [CD]; p=0.012 for ulcerative colitis [UC]) and biologics (p=0.004 for CD; p=0.008 for UC).

However, the presence of HIV infection did not alter the disease course, which was measured using a severity composite criterion, when compared against the noninfected group. The hazard ratios were 1.3 (95 percent confidence interval [CI], 0.7–2.4) for CD (p=0.45) and 1.1 (95 percent CI, 0.5–2.7) for UC (p=0.767).

The overall drug safety profiles of immunosuppressants and biologics were comparable in the infected and noninfected groups.

It is established that both IBD and HIV can modify innate and adaptive immunity in the intestinal mucosa. The present data suggest that HIV has the potential to attenuate IBD. Furthermore, the safety findings are reassuring, especially for clinicians, providing support for treating patients according to current recommendations.