Managing IBD Patients with Concomitant HIV Infection - a Systematic Review

Curr Gastroenterol Rep. 2024 Jan;26(1):1-8. doi: 10.1007/s11894-023-00914-4. Epub 2024 Jan 5.

Abstract

Purpose of review: Inflammatory Bowel Disease (IBD) is a chronic GI inflammatory condition induced by a dysregulated immune system activation, whereas HIV infection causes depletion of the immune system, inducing immunosuppression. Given the increasing incidence of IBD across the globe, including in developing countries, the co-prevalence of both conditions is expected to increase. Herein, we systematically review the data describing disease course when both pathologies co-exist.

Recent findings: Overall, the co-prevalence of IBD and HIV is around 0.1 to 2%. While IBD does not seem to affect HIV course, the opposite is controversial, as some studies report milder IBD phenotype, with fewer disease relapses especially when CD4 + counts are lower than 200 cells/µL. Despite growing evidence to support the safety of the use of immunosuppressants and biologics in IBD-HIV infected patients, these classes of drugs are used in less than 50% of patients, as compared to non-HIV infected IBD patients. There is a need for more studies on disease course and safety of IBD medications in the setting of IBD.

Keywords: Crohn’s Disease; Human Immunodeficiency Virus; Inflammatory Bowel Disease; Management; Ulcerative Colitis.

Publication types

  • Systematic Review

MeSH terms

  • Colitis, Ulcerative* / complications
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Immunosuppression Therapy
  • Immunosuppressive Agents / adverse effects
  • Inflammatory Bowel Diseases* / complications
  • Inflammatory Bowel Diseases* / drug therapy

Substances

  • Immunosuppressive Agents