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The coexistence of Human Immunodeficiency Virus (HIV) infection and Systemic Lupus Erythematosus (SLE) is an uncommon and diagnostically complex phenomenon due to their contrasting immunopathological mechanisms. HIV typically causes immune suppression, while SLE is driven by autoimmune hyperactivity. We report a rare case of a 28-year-old HIV-positive female on long-term HAART (DTG/3TC/TDF) with good compliance and viral suppression, who presented with facial puffiness, lower limb edema, oliguria progressing to anuria, and fever. Laboratory findings revealed nephrotic-range proteinuria, hypoalbuminemia, low complement levels, and positive autoimmune serologies (dsDNA, nucleosome antibodies). She developed acute kidney injury requiring hemodialysis. Renal biopsy confirmed Class IIIA + V lupus nephritis with a full-house immunofluorescence pattern. Initial immunosuppressive treatment was delayed due to thrombocytopenia but was later initiated with pulse steroids followed by oral steroids and mycophenolate mofetil. ART was modified to minimize nephrotoxicity. The patient showed clinical improvement with recovery of renal function and stabilization of urinary output.
This case illustrates the need for heightened clinical suspicion for autoimmune diseases like SLE in HIV-infected individuals, particularly in the setting of immune reconstitution. It also emphasizes the importance of individualized treatment strategies balancing immunosuppression with infection risk and ART adjustments. Early diagnosis and multidisciplinary management are crucial in optimizing outcomes.
"A Rare Coexistence of HIV and Systemic Lupus Erythematosus with Lupus Nephritis", International Journal of Science & Engineering Development Research (www.ijrti.org), ISSN:2455-2631, Vol.10, Issue 4, page no.a650-a652, April-2025, Available :http://www.ijrti.org/papers/IJRTI2504083.pdf
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2456-3315 | IMPACT FACTOR: 8.14 Calculated By Google Scholar| ESTD YEAR: 2016
An International Scholarly Open Access Journal, Peer-Reviewed, Refereed Journal Impact Factor 8.14 Calculate by Google Scholar and Semantic Scholar | AI-Powered Research Tool, Multidisciplinary, Monthly, Multilanguage Journal Indexing in All Major Database & Metadata, Citation Generator