Systemic lupus erythematosus and drug-induced lupus in people living with HIV

Volgina G.V., Frolova N.F., Zubkin M.L.

1) Russian University of Medicine, Moscow, Russian Federation; 2) Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department, Moscow, Russian Federation; 3) Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russian Federation; 4) Branch of the S.M. Sechenov Military Medical Academy in the Moscow, Ministry of Defense of the Russian Federation, Moscow, Russian Federation

The combination of HIV infection, systemic lupus erythematosus (SLE), and drug-induced lupus (DIL) poses a diagnostic challenge due to overlapping symptoms. This review summarizes current data on the epidemiology, pathogenesis, and differential diagnosis of SLE and DIL in people living with HIV (PLHIV). Key pathogenetic mechanisms - genetic predisposition, epigenetic dysregulation, and the role of antiretroviral therapy as a trigger - are discussed. A diagnostic algorithm based on the temporal relationship with drug administration, the presence of antinuclear and antihistone antibodies, and symptom regression after discontinuation is proposed.
Differential diagnosis between idiopathic SLE, infectious complications, immune reconstitution syndrome, and drug reactions is a primary task.

Keywords

About the Authors

Galina V. Volgina – Dr.Sci. (Med.), Professor, Department of Nephrology, Russian University of Medicine. Address: Bldg. 4, 1A Kuskovskaya St., Moscow, 111398; e-mail: volginagv@mail.ru. ORCID: 0000-0002-7771-4074
Nadiya F. Frolova – Cand.Sci. (Med.), Deputy Chief Physician for Nephrology Care, Head of the Interdistrict Nephrology Center, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow 123182; Associate Professor, Department of Nephrology, Russian University of Medicine, Russian Federation. Address: Bldg. 4, 1A Kuskovskaya St., Moscow, 111398; e-mail: nadiya.frolova@yandex.ru. ORCID: 0000-0002-6086-5220
Mikhail L. Zubkin – Dr.Sci. (Med.), Professor, Nephrologist, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow, 123182; Chief Researcher, Head of the Clinical Diagnostic Department, Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being. Address: 10 Admiral Makarov St., Moscow, 125212; Professor, Department of Emergency Therapy, Branch of the S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation. Address: 7 Malaya Cherkizovskaya St., Moscow, 107392. E-mail: m-zubkin@yandex.ru. ORCID: 0000-0001-5271-1902

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