Factors associated with psoriasis in a French Nationwide HIV cohort: the independent role of HLA-B*57: 01.

OBJECTIVE: Psoriasis is a T-cell-mediated inflammatory disease with genetic factors involved in its etiopathogenesis. In non-HIV populations, HLA-B*57:01 has been associated with a higher risk of psoriasis. The aim of this study was to investigate demographic and immunovirological characteristics associated with psoriasis, and to assess whether HLA-B*57:01 is associated with psoriasis among people living with HIV (PLHIV) followed in a large French multicenter Dat'AIDS cohort.

METHODS: All PLHIV followed up from January 2000 to December 2018 with an available result for HLA-B*57:01 were included. Logistic regression models were used to identify associations between psoriasis (outcome variable) and explanatory variables.

RESULTS: Among 31,076 PLHIV, the overall prevalence of psoriasis and HLA-B*57:01 were 2.25% and 4.73%, respectively and varied according to ethnicity. By multivariate analysis, male gender (OR 1.81 [95% CI, 1.46 - 2.24], p < 10), positive HLA-B*57:01 (OR 2.66 [95% CI, 2.12 - 3.33], p < 10), nadir CD4 cell count <200/mm (OR 1.41 [95% CI, 1.19 - 1.67], p < 10) and positive HCV serology (OR 1.45 [95% CI, 1.20 - 1.76], p < 10) were significantly associated with a higher risk of psoriasis. Being born in West and Central Africa (OR 0.15 [95% CI, 0.10 - 0.25], p < 10), the Caribbean islands (OR 0.14 [95% CI, 0.05 - 0.45], p = 0.0008) or Latin America (OR 0.31 [95% CI, 0.14 - 0.69], p = 0.004) was associated with a lower risk of psoriasis compared to patients born in mainland France.

CONCLUSION: PLHIV carrying HLA-B*57:01 have around a 3-fold increased risk of psoriasis. This association might provide a possible explanation for the observed differences in psoriasis prevalence between ethnic groups.