HIV and Autoimmunity

The combination of immune dysfunction in patients with HIV infection and AIDS, and the development of autoimmune diseases is intriguing. Yet, the spectrum of reported autoimmune phenomena in these patients is increasing. This wide range of reported autoimmune diseases is because of different patient selection, and the association with the development of AIDS. An infectious trigger for immune activation is one of the postulated mechanisms in autoimmunity and derives from molecular mimicry. During frank loss of immunocompetence, autoimmune diseases that are predominantly T cell subtype CD8 driven may predominate. Multiple anti-retroviral drug therapy for patients with AIDS provides prolonged survival and immune restoration, a setting where autoimmune diseases develop. This chapter proposes a staging of autoimmune manifestations related to HIV/AIDS manifestations and CD4 count that may be beneficial in identifying the type of autoimmune disease and establishing the proper therapy. The chapter describes the various autoimmune diseases that develop in HIV/AIDS patients through possible mechanisms related to immune activation.