HIV Infection Is Associated With a Less Aggressive Phenotype of Inflammatory Bowel Disease: A Multicenter Study of the ENEIDA Registry.
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Calafat Margalida, Suria Carles, Mesonero Francisco, de Francisco Ruth, Yagüe Caballero Carmen, de la Peña Luisa, Hernández-Camba Alejandro, Marcé Ainhoa, Gallego Beatriz, Martín-Vicente Noelia, Rivero Montserrat, Iborra Marisa, Guerra Iván, Carrillo-Palau Marta, Madero Lucía, Burgueño Beatriz, Monfort David, Torres Gisela, Teller Marta, Ferrer Rosique Juan Ángel, Vega Villaamil Pablo, Roig Cristina, Ponferrada-Diaz Angel, Betoré Glaría Elena, Zabana Yamile, Gisbert Javier P, Busquets David, Alcaide Noelia, Camps Blau, Legido Jesús, González-Vivo Maria, Bosca-Watts Marta Maia, Pérez-Martínez Isabel, Casas Deza Diego, Guardiola Jordi, Arranz Hernández Laura, Navarro Mercè, Gargallo-Puyuelo Carla J, Cañete Fiorella, Mañosa Míriam, Domènech Eugeni, ENEIDA Registry of GETECCU
Аннотация
METHODS: Case-control, retrospective study includes all HIV-positive patients diagnosed with IBD in the Nationwide study on genetic and environmental determinants of inflammatory bowel disease registry. Patients with positive HIV serology (HIV-IBD) were compared with controls (HIV seronegative), matched 1:3 by year of IBD diagnosis, age, sex, and type of IBD.
RESULTS: A total of 364 patients (91 HIV-IBD and 273 IBD controls) were included. In the whole cohort, 58% had ulcerative colitis, 35% had Crohn's disease (CD), and 7% were IBD unclassified. The HIV-IBD group presented a significantly higher proportion of proctitis in ulcerative colitis and colonic location in CD but fewer extraintestinal manifestations than controls. Regarding treatments, nonbiological therapies (37.4% vs 57.9%; P = 0.001) and biologicals (26.4% vs 42.1%; P = 0.007), were used less frequently among patients in the HIV-IBD group. Conversely, patients with HIV-IBD developed more OI than controls, regardless of nonbiological therapy use. In the multivariate analysis, HIV infection (odds ratio 4.765, 95% confidence interval (CI) 2.48-9.14; P < 0.001) and having ≥1 comorbidity (OR 2.445, 95% CI 1.23-4.85; P = 0.010) were risk factors for developing OI, while CD was protective (OR 0.372, 95% CI 0.18-0.78; P = 0.009).
DISCUSSION: HIV infection seems to be associated with a less aggressive phenotype of IBD and a lesser use of nonbiological therapies and biologicals but entails a greater risk of developing OI.