Yen Yung-Feng, Jen I-An, Chen Marcelo, Lan Yu-Ching, Lee Chun-Yuan, Chuang Pei-Hung, Lee Yun, Arthur Chen Yi-Ming
*Section of Infectious Diseases, Taipei City Hospital, Taipei City, Taiwan; †School of Medicine, National Yang-Ming University, Taipei, Taiwan; ‡Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; §Department and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; ‖Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan; ¶Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; #Department of Health Risk Management, China Medical University, Taiwan; **Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ††Center for Prevention and Treatment of Occupational Injury and Diseases, Taipei Veterans General Hospital, Taipei, Taiwan; ‡‡Division of Clinical Toxicology and Occupational Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; and §§Department of Microbiology and Institute of Medical Research, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Acquir Immune Defic Syndr. 2017 Aug 15;75(5):493-499. doi: 10.1097/QAI.0000000000001431.
HIV can cause an imbalance of T lymphocytes, which may contribute to the onset of psoriasis. However, the association of HIV with incident psoriasis has not been extensively studied.
The aim of this nationwide population-based cohort study was to determine the association of HIV with incident psoriasis.
Since January 1, 2000, we identified adult people living with HIV/AIDS (PLWHA) from the Taiwan National Health Insurance Research Database. A control cohort without HIV infection, matched for age and sex, was selected for comparison. All patients were followed until December 31, 2012, and observed for the occurrence of psoriasis. The time-dependent Cox proportional hazards model was used to determine the association of HIV with incident psoriasis, while considering death as a competing risk event.
Of the 102,070 patients (20,294 PLWHA and 81,776 matched controls), 248 (0.24%) had incident psoriasis during a mean follow-up period of 5.53 years, including 81 (0.40%) PLWHA and 171 (0.21%) controls. After adjusting for age, sex, and comorbidities, HIV infection was found to be an independent risk factor for incident psoriasis (adjusted hazard ratio, 1.80; 95% confidence interval: 1.38 to 2.36).
The population of PLWHA is living longer; clinicians need to be aware of their higher risk of psoriasis.
HIV可导致T淋巴细胞失衡，这可能促使银屑病的发病。然而，HIV与新发银屑病之间的关联尚未得到广泛研究。
这项基于全国人群的队列研究旨在确定HIV与新发银屑病之间的关联。
自2000年1月1日起，我们从台湾国民健康保险研究数据库中识别出成年HIV/AIDS患者（PLWHA）。选取年龄和性别匹配的无HIV感染对照队列进行比较。所有患者随访至2012年12月31日，观察银屑病的发生情况。采用时间依赖性Cox比例风险模型确定HIV与新发银屑病之间的关联，同时将死亡视为竞争风险事件。
在102,070例患者（20,294例PLWHA和81,776例匹配对照）中，在平均5.53年的随访期内，248例（0.24%）发生了新发银屑病，其中包括81例（0.40%）PLWHA和171例（0.21%）对照。在调整年龄、性别和合并症后，发现HIV感染是新发银屑病的独立危险因素（调整后风险比为1.80；95%置信区间：1.38至2.36）。
PLWHA的寿命在延长；临床医生需要意识到他们患银屑病的风险更高。
