Psoriasis Patients with Human Immunodeficiency Virus Infection: Data from the Malaysian Psoriasis Registry

ABSTRACT

Background@#Psoriasis can be a presenting feature of human immunodeficiency virus (HIV) infection. Our objective was to determine the frequency of HIV infection among patients with psoriasis and to describe the clinical features, treatment and quality of life in this population.@*Methods@#This is a multi-centre retrospective cross-sectional study of psoriasis patients who were registered to the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018.@*Results@#Of a total of 21,735 patients registered, 105 (0.5%) had HIV infection. Among these patients, 90 (85.0%) were male, mean age was 40.90 ± 10.85 years, and plaque psoriasis was the most frequently encountered presentation (85.7%). Significantly more patients with HIV had severe psoriasis (61.3% vs 49.9%, p=0.043), face and neck (62.7% vs 51.4%, p=0.022) involvement, and nail disease (69.9% vs 56.2%, p=0.005) compared to those without HIV. Only n patients (8.7%) had psoriatic arthropathy, and only 9 (8.8%) received systemic therapy, namely acitretin and methotrexate. None received a biologic, and only one patient was treated with narrowband ultraviolet-B therapy. The mean Dermatology Life Quality Index (DLQI) score at enrolment was 10.98 ± 7.07 for the HIV cohort compared to 8.68 ± 6.60 for the non-HIV cohort (t=2.190, p=0.029). More patients with HIV reported a DLQI score >10 compared to those without HIV (51.5% vs 40.2%, p=0.021).@*Conclusion@#The frequency of HIV infection among patients with psoriasis in the MPR was 0.5%. Patients with HIV had more severe disease, more nail, face and neck involvement, and greater impairment of quality of life. Treatment of HIV patients with psoriasis remains conservative in Malaysia.