Case report: Safety and efficacy of adalimumab in treating difficult-to-treat rheumatoid arthritis in a human immunodeficiency virus-positive patient, one year follow-up
Rheumatoid arthritis (RA) is a joint-disabling inflammatory disease associated with the pathology of synovitis. Some patients with RA are difficult to treat, using disease-modifying anti-rheumatic drugs (DMARDs). Biology and targeted synthetic DMARDs (b/tsDMARDs) are options for patients with RA. Ac...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.942642/full |
| _version_ | 1818010966869147648 |
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| author | Jing-Wen Chen Jing-Wen Chen Guo-Shu Deng Guo-Shu Deng Wen-Shuang Zhang Wen-Shuang Zhang Ming-Ying Zhang Ming-Ying Zhang Tong Guan Tong Guan Qiang Xu Qiang Xu |
| author_facet | Jing-Wen Chen Jing-Wen Chen Guo-Shu Deng Guo-Shu Deng Wen-Shuang Zhang Wen-Shuang Zhang Ming-Ying Zhang Ming-Ying Zhang Tong Guan Tong Guan Qiang Xu Qiang Xu |
| author_sort | Jing-Wen Chen |
| collection | DOAJ |
| description | Rheumatoid arthritis (RA) is a joint-disabling inflammatory disease associated with the pathology of synovitis. Some patients with RA are difficult to treat, using disease-modifying anti-rheumatic drugs (DMARDs). Biology and targeted synthetic DMARDs (b/tsDMARDs) are options for patients with RA. Acquired immunodeficiency syndrome (AIDS) is an infectious disease caused by the human immunodeficiency virus (HIV). Adalimumab is an anti-tumor necrosis factor therapy commonly used in patients with RA. However, there are no reports or related data on patients with RA-HIV/AIDS treated with adalimumab are available. In this report, we described the first successful case of a 60-year-old HIV-positive woman with difficult-to-treat RA treated with ADA after being screened for hepatitis virus, latent tuberculosis (LTBI), and other infections. She contracted HIV from sexual exposure while on adalimumab therapy. As the patient was resistant to first-line DMARDs, she continued adalimumab along with the initiation of highly active antiretroviral therapy (HAART). The patient was treated with adalimumab therapy for a year; her CD4+ lymphocyte count was normal, HIV-1 RNA decreased, and no new infections were triggered. The patient achieved clinical remission of RA. In conclusion, adalimumab is a safe option for patients with RA-HIV and may slow the progression of HIV infection. Furthermore, HAART has the potential to reduce joint pain and fatigue in patients with difficult-to-treat RA.ConclusionsAdalimumab is a safe option for patients with RA-HIV, and may slow down the progression of HIV infection. The HAART therapy has the potential to reduce joint pain and fatigue in patients with difficult-to-treat RA. |
| first_indexed | 2024-04-14T06:01:26Z |
| format | Article |
| id | doaj.art-179a0ac079354c5abc73927c3d1957ae |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-14T06:01:26Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-179a0ac079354c5abc73927c3d1957ae2022-12-22T02:08:44ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-08-011310.3389/fimmu.2022.942642942642Case report: Safety and efficacy of adalimumab in treating difficult-to-treat rheumatoid arthritis in a human immunodeficiency virus-positive patient, one year follow-upJing-Wen Chen0Jing-Wen Chen1Guo-Shu Deng2Guo-Shu Deng3Wen-Shuang Zhang4Wen-Shuang Zhang5Ming-Ying Zhang6Ming-Ying Zhang7Tong Guan8Tong Guan9Qiang Xu10Qiang Xu11The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaRheumatoid arthritis (RA) is a joint-disabling inflammatory disease associated with the pathology of synovitis. Some patients with RA are difficult to treat, using disease-modifying anti-rheumatic drugs (DMARDs). Biology and targeted synthetic DMARDs (b/tsDMARDs) are options for patients with RA. Acquired immunodeficiency syndrome (AIDS) is an infectious disease caused by the human immunodeficiency virus (HIV). Adalimumab is an anti-tumor necrosis factor therapy commonly used in patients with RA. However, there are no reports or related data on patients with RA-HIV/AIDS treated with adalimumab are available. In this report, we described the first successful case of a 60-year-old HIV-positive woman with difficult-to-treat RA treated with ADA after being screened for hepatitis virus, latent tuberculosis (LTBI), and other infections. She contracted HIV from sexual exposure while on adalimumab therapy. As the patient was resistant to first-line DMARDs, she continued adalimumab along with the initiation of highly active antiretroviral therapy (HAART). The patient was treated with adalimumab therapy for a year; her CD4+ lymphocyte count was normal, HIV-1 RNA decreased, and no new infections were triggered. The patient achieved clinical remission of RA. In conclusion, adalimumab is a safe option for patients with RA-HIV and may slow the progression of HIV infection. Furthermore, HAART has the potential to reduce joint pain and fatigue in patients with difficult-to-treat RA.ConclusionsAdalimumab is a safe option for patients with RA-HIV, and may slow down the progression of HIV infection. The HAART therapy has the potential to reduce joint pain and fatigue in patients with difficult-to-treat RA.https://www.frontiersin.org/articles/10.3389/fimmu.2022.942642/fullrheumatoid arthritisadalimumabTNFhuman immunodeficiency virusAIDS |
| spellingShingle | Jing-Wen Chen Jing-Wen Chen Guo-Shu Deng Guo-Shu Deng Wen-Shuang Zhang Wen-Shuang Zhang Ming-Ying Zhang Ming-Ying Zhang Tong Guan Tong Guan Qiang Xu Qiang Xu Case report: Safety and efficacy of adalimumab in treating difficult-to-treat rheumatoid arthritis in a human immunodeficiency virus-positive patient, one year follow-up Frontiers in Immunology rheumatoid arthritis adalimumab TNF human immunodeficiency virus AIDS |
| title | Case report: Safety and efficacy of adalimumab in treating difficult-to-treat rheumatoid arthritis in a human immunodeficiency virus-positive patient, one year follow-up |
| title_full | Case report: Safety and efficacy of adalimumab in treating difficult-to-treat rheumatoid arthritis in a human immunodeficiency virus-positive patient, one year follow-up |
| title_fullStr | Case report: Safety and efficacy of adalimumab in treating difficult-to-treat rheumatoid arthritis in a human immunodeficiency virus-positive patient, one year follow-up |
| title_full_unstemmed | Case report: Safety and efficacy of adalimumab in treating difficult-to-treat rheumatoid arthritis in a human immunodeficiency virus-positive patient, one year follow-up |
| title_short | Case report: Safety and efficacy of adalimumab in treating difficult-to-treat rheumatoid arthritis in a human immunodeficiency virus-positive patient, one year follow-up |
| title_sort | case report safety and efficacy of adalimumab in treating difficult to treat rheumatoid arthritis in a human immunodeficiency virus positive patient one year follow up |
| topic | rheumatoid arthritis adalimumab TNF human immunodeficiency virus AIDS |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.942642/full |
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