Exploring the Impact of Guselkumab and Risankizumab on Psoriasis in HIV-Positive Patients: Insights From Four Italian Centers.

HIV-positive patients with psoriasis often face delays in accessing biologic therapies due to their exclusion from clinical trials and concerns about the impact of immunomodulatory drugs on viral replication. Anti-IL-23 therapies, such as risankizumab and guselkumab, have shown great promise thanks to their strong efficacy and favourable safety profiles. A case series from four Italian centres reported sustained effectiveness of these drugs, with no observed effects on viral replication or immune parameters in HIV-positive patients. Although the number of cases is limited, these therapies appear to be a compelling option for patients with extensive or treatment-resistant psoriasis.