Effective Etanercept Treatment for Psoriatic Arthritis Complicating Concomitant Human Immunodeficiency Virus and Hepatitis C Virus Infection

High levels of tumor necrosis factor-alpha (TNF-alpha) are associated with hepatitis C virus (HCV) infection and all stages of human immunodeficiency virus (HIV) infection. TNF-alpha may have a role in both the pathogenesis and the response to treatment of these chronic viral diseases. We describe a 42-year-old HIV/HCV coinfected hemophiliac man who developed psoriasis and severe psoriatic arthritis not responding to combination treatment with methotrexate and cyclosporin A. Treatment with etanercept 25 mg twice weekly was followed by remission of the joint inflammation and improvement of the exanthem. This is the first report of anti-TNF-alpha treatment for rheumatic complications in a patient with both HIV and HCV infection.