Alterations in HIV expression in AIDS patients with psoriasis or pruritus treated with phototherapy

• Published in: Journal of the American Academy of Dermatology 1999, Vol.40 (1), p.48-60
• Main Authors: Breuer-McHam, Joan, Marshall, Gailen, Adu-Oppong, Ahmed, Goller, Michelle, Mays, Steven, Berger, Tim, Lewis, Dorothy E., Duvic, Madeleine
• Format: Article
• Language: English
• Subjects: Acquired Immunodeficiency Syndrome - complications; Acquired Immunodeficiency Syndrome - immunology; Acquired Immunodeficiency Syndrome - virology; Adult; AIDS/HIV; Biological and medical sciences; Case-Control Studies; CD4-CD8 Ratio; Cytokines - blood; Female; HIV Core Protein p24 - blood; HIV-1 - isolation & purification; HIV-1 - radiation effects; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Prospective Studies; Pruritus - complications; Pruritus - drug therapy; Pruritus - radiotherapy; Pruritus - virology; Psoriasis - complications; Psoriasis - drug therapy; Psoriasis - radiotherapy; Psoriasis - virology; PUVA Therapy; RNA, Viral - blood; Ultraviolet Therapy; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/S0190-9622(99)70527-X

Background: Ultraviolet light (UVL) upregulates HIV transcription in vitro and in transgenic mice. AIDS-associated psoriasis and pruritus respond to phototherapy. Objective: Our goal was to determine the effect of phototherapy on viral load and immunologic parameters in HIV-positive patients. Methods: T cell subsets, p24, plasma cytokines, serum or plasma HIV-RNA, dosage, and antivirals were assessed in HIV-positive patients and negative controls receiving 6 weeks of phototherapy with UVB and in untreated controls. Results: Phototherapy improved skin conditions without significantly affecting T cell numbers. Plasma p24 increased 2-fold ( P = .055) and HIV-RNA levels 4-fold ( P = .022) 6 weeks from baseline in patients who entered the trial before March 1995. Later patients who were mostly receiving combination antiviral therapy showed a 4-fold reduction in serum HIV-RNA ( P = .012) at 2 weeks. The effect of UVB on viral load at 6 weeks was dependent on the baseline level ( P = .006). IL-10 increased and was inversely related to HIV-RNA levels ( P = .0267). Conclusion: Phototherapy is associated with HIV load alterations, depending on patients’ initial HIV-RNA, antiviral therapy, skin type, and UVL dosage. (J Am Acad Dermatol 1999;40:48-60.)