Systematic review of biologic use for psoriasis in HIV-positive individuals from 2018 to 2024

Psoriasis is a chronic, inflammatory systemic condition mediated by T-lymphocyte activation. In patients with concomitant human immunodeficiency virus (HIV) infection, treatment of psoriasis remains a therapeutic challenge due to disruptions in the immune system targeting the quality and quantity of T-cell counts. Limited data exists on the knowledge of the utilization and tolerance of small-molecule and biologic therapies used for psoriasis in HIV-positive (HIV +) individuals. This study aims to provide an updated review detailing reports of efficacy and safety trends currently reported in the literature. A systematic review of PubMed, Cochrane, and Embase databases between January 2018 and April 2024 was performed, which included original investigations, reviews, case reports, and series of reported individuals with a prior diagnosis of psoriasis, and either a previous, or novel diagnosis of HIV during initiation of treatment. 19 articles with 24 cases were included in this review, including treatments apremilast (n = 5), adalimumab (n = 1), etanercept (n = 2), ustekinumab (n = 4), secukinumab (n = 5), ixekizumab (n = 2), brodalumab (n = 1), guselkumab (n = 1), and risankizumab (n = 3). Treatments were effective at improving cutaneous symptoms of psoriasis in all cases and 2 cases reported alleviation of psoriatic arthritis. Adverse events were seldom reported and were managed without interruption of medication. Higher evidence research is necessary to objectively determine the efficacy and safety profiles of these therapies in HIV + individuals.