Background:
Human immunodeficiency virus (hiv) infection depletes cd4+ lymphocytes, which may benefit patients with inflammatory bowel disease (ibd). the aim was to compare the course of ibd in hiv patients with a matched group of ibd seronegative patients.
Methods:
A total of 20 ibd (14 crohn's disease, 6 ulcerative colitis) hiv infected patients and 40 matched control seronegative ibd patients (2 controls per case) were compared regarding relapse of their disease. the cd4+ count was followed every 6 months and a value of < or =500 cells/microl was used to define patients with immunosuppression. relapse rates per year of follow-up were compared among the 2 groups and survival curves for cumulative remission rates were compared with a log-rank test. multivariate analysis was used to discriminate among the impact of different variables on the risk of ibd relapse.
Results:
The median duration of follow-up was 8.4 years (range 0.6-18 years). the mean relapse rate for the hiv+ibd group was 0.016/year of follow-up as compared to 0.053/year of follow-up for the ibd-matched control group (p = 0.032). regarding the hiv-positive/ibd group, 14 patients were immunosuppressed at any given time during the follow-up period. none of these patients experienced an ibd relapse, whereas 3 out of the 6 without immunosuppression relapsed (p = 0.017). according to the multivariate analysis, hiv status was the only risk factor independently associated with a lower probability of ibd relapse.
Conclusions:
Hiv infection reduces the relapse rates in ibd patients and this may be attributed to the lower cd4+ counts seen in these patients.