Development of Inflammatory Bowel Disease in HIV Patients: A Danish Cohort Study (1983-2018) With American Validation (1999-2018)

Overview

Journal Gastro Hep Adv

Specialty Gastroenterology

Date 2022 Dec 19

PMID 36531445

Authors

Rahma Elmahdi

Gursimran S Kochhar

Aske T Iversen

Kristine H Allin

Parambir S Dulai

Aakash Desai

Tine Jess

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Human immunodeficiency virus (HIV) infection is associated with several immune-mediated disorders. However, the risk of inflammatory bowel disease (IBD) in people living with HIV (PLWH) remains unclear. We aimed to assess the risk of IBD among PLWH using a nationwide, population-based Danish cohort and to validate findings in a large American insurance-based database.

Methods: Using Danish registries (1983-2018), we identified 8995 PLWH and age- and sex-matched them to 449,750 HIV-negative individuals. Cox regression analysis was undertaken to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for IBD diagnosis. Results were stratified by sex, age, and year of HIV diagnosis. Using an American insurance-based cohort, Explorys (1999-2018), we assessed the prevalence odds ratio (OR) and 95% CI of IBD diagnosis in PLWH compared with HIV-negative individuals.

Results: IBD diagnosis among PLWH in Denmark was increased (HR: 2.25, 95% CI: 1.78-2.83) compared with matched HIV-negative individuals. This was seen for both Crohn's disease (HR: 2.25, 95% CI: 1.47-3.44) and ulcerative colitis (HR: 2.24, 95% CI: 1.70-2.96) and in male (HR: 2.75, 95% CI: 2.15-3.52) but not female (HR: 0.93, 95% CI: 0.48-1.79) PLWH. Explorys analysis also showed an increased odds of IBD diagnoses among PLWH (OR: 1.41; 95% CI: 1.35-1.49).

Conclusion: This study finds an increased risk of IBD diagnosis among PLWH in both a Danish and US cohort, highlighting a need to consider IBD in PLWH with new-onset gastrointestinal symptoms. Further research into the role of antiretroviral therapy in this relationship is required.

Citing Articles

HIV infection increases the risk of inflammatory bowel disease: a systematic review and meta-analysis.

Huang W, Zhang Y, Wang P, Song C, Lu X, Feng M BMC Infect Dis. 2024; 24(1):1030.

PMID: 39333960 PMC: 11428435. DOI: 10.1186/s12879-024-09964-z.

Managing IBD Patients with Concomitant HIV Infection - a Systematic Review.

Sousa H, Barroso J, Tavares R, Torres J Curr Gastroenterol Rep. 2024; 26(1):1-8.

PMID: 38180722 DOI: 10.1007/s11894-023-00914-4.

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