中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (8): 559-563.doi: 10.12144/zgmfskin202508559

• 论著 • 上一篇    下一篇

生物制剂治疗银屑病合并HIV感染八例临床分析

高靖雅1,胡宏香1,肖月1,夏登梅2,江露3,李薇1   

  1. 1 四川大学华西医院皮肤性病科，四川成都，610041； 2 四川大学华西第二医院皮肤科，出生缺陷与相关妇儿疾病教育部重点实验室，四川成都，610066； 3 四川大学华西医院门诊部，四川成都，610041
  • 出版日期:2025-08-15 发布日期:2025-07-31

Clinical analysis of 8 cases with plaque psoriasis complicated by HIV infected treated with biologics

GAO Jingya1, HU Hongxiang1, XIAO Yue1, XIA Dengmei2, JIANG Lu3, LI Wei1   

  1. 1 Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu 610041, China; 2 Department of Dermatology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu 610066, China; 3 Outpatient Department, West China Hospital, Sichuan University, Chengdu 610041, China
  • Online:2025-08-15 Published:2025-07-31

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摘要： 目的：评价生物制剂在银屑病合并HIV感染患者中的疗效与安全性。方法：回顾性分析2020年11月至2024年9月于我院皮肤科门诊使用生物制剂治疗的HIV感染合并中重度斑块状银屑病患者的临床资料。使用的生物制剂包括司库奇尤单抗、阿达木单抗和古塞奇尤单抗，同时持续进行高效抗逆转录病毒治疗（HAART）。通过银屑病面积和严重程度指数（PASI）、体表受累面积（BSA）、患者总体评估（PGA）、皮肤病生活质量指数（DLQI）等指标评估治疗效果，并监测CD4+T淋巴细胞计数及不良事件。结果：8例患者均为男性斑块状银屑病且HIV感染处于无症状期，平均年龄（39.5 ± 10.8）岁。其中87.5%存在高危性生活史，5例银屑病发病早于HIV感染（62.5%）。皮损累及头面颈部、上肢与躯干（100%）、下肢（87.5%）、生殖器（25%）、掌跖与甲（12.5%），3例合并银屑病关节炎（37.5%）。治疗后PASI、BSA、DLQI、PGA均显著改善（P＜0.05），CD4+T淋巴细胞计数平均值升高；2例达PASI 100，2例达PASI 90，3例达PASI 75，5例达DLQI 0/1。8例患者均无不良事件报告。结论：生物制剂治疗HIV感染合并斑块状银屑病具有良好的疗效和安全性，可显著改善皮损和生活质量。

关键词: 银屑病, 艾滋病, 人类免疫缺陷病毒, 生物制剂

Abstract: Objective: To evaluate the efficacy and safety of biologics in patients with psoriasis complicated by HIV. Methods: A retrospective analysis was conducted on clinical data of patients with moderate-to-severe plaque psoriasis and HIV infection who were treated with biologics in the dermatology outpatient clinic of our hospital from November 2020 to September 2024. The biologics used included secukinumab, adalimumab, and guselkumab, with concurrent continuous highly active antiretroviral therapy (HAART). Treatment efficacy was assessed using the psoriasis area and severity index (PASI), body surface area (BSA), physician global assessment (PGA), and dermatology life quality index (DLQI). CD4+ T-cell counts and adverse events were monitored. Results: A total of 8 male patients with plaque psoriasis and asymptomatic HIV infection were included, with a mean age of 39.5 ± 10.8 years. Among them, 87.5% had a high-risk sexual history, and 5 patients (62.5%) had psoriasis onset before HIV infection. Skin lesions affected the head, face, neck, upper limbs, and trunk (100%), the lower limbs (87.5%), the genital area (25.0%), and the palms, soles, and nails (12.5%). Three patients (37.5%) had psoriatic arthritis. Post-treatment, significant improvements were observed in PASI, BSA, DLQI, and PGA scores (P＜0.05), and the average CD4+ T lymphocyte count increased. Two patients achieved PASI 100, two achieved PASI 90, three achieved PASI 75, and five achieved DLQI 0/1. No adverse events were reported. Conclusions: Biologics show favorable efficacy and safety in patients with plaque psoriasis complicated with HIV, which significantly improves skin lesions and quality of life without causing adverse events.

Key words: psoriasis, AIDS, HIV, biologics