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