The use of dupilumab in patients with HIV

Abstract

Background: The goal of this study was to complete the first Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) based systematic review of dupilumab use in patients living with human immunodeficiency virus (HIV).

Methods: A systematic literature review was performed using PubMed, Google Scholar, Ovid MEDLINE, and Science Direct databases as well as an internal review using University of Virginia's electronic medical record system. All reports of dupilumab use in patients with confirmed HIV were included.

Results: 14 published cases comprising 23 patients were identified and included in the review. Additionally, four unpublished cases from our own institution were included for a final cohort of 27 patients. A total of 25 patients (96%) were observed to have a clinical response, defined as improvement or complete resolution of their cutaneous or asthmatic symptoms. In 100% of patients, viral load improved or did not change, and in 80% of patients, CD4 counts remained stable. Side effects occurred in 48% of patients but were self-limited.

Discussion and conclusions: All reported cases indicate that dupilumab is safe in patients with HIV with stable CD4 counts and low viral loads. Most patients had significant improvement within 2 months of treatment with mild side effects.

Keywords: General dermatology; HIV; TH2 phenotype; asthma; atopic dermatitis; dupilumab; human immunodeficiency virus; medical dermatology; prurigo nodularis.