LAUSR

INTRODUCTION Since the introduction of modern antiretroviral treatment for HIV and hepatitis C virus (HCV), the pattern of autoimmune diseases (AD) in people living with HIV (PWH) might have changed. METHODS A retrospective study in a cohort of 5665 PWH at the HIV Clinic of Hospital Universitario La Paz (Spain) to study the prevalence of AD from January 1990 to June 2020. We divided the timeline in four periods: <1996, 1996-2006, 2006-2015, 2015-2020. RESULTS 369 participants were diagnosed with at least one AD, with a prevalence of 5.3% (95% CI 4.7-5.9). 302 (81%) participants were diagnosed simultaneously or after HIV diagnosis. Most prevalent diseases were immune thrombopenia (n=90), cutaneous psoriasis (n=52), autoimmune thyroid disorders (n=36), spondylarthritis (n=24), and inflammatory bowel disease (n=21). There was a significant trend for more AD in recent periods (p=0.037). In recent years participants with AD were older, had a long time since HIV diagnosis, and had higher CD4+ T-cell count and higher CD4+ T-cell nadir (temporal linear trend p<0.001). There was a change in the pattern of AD over time with a decrease in immune thrombopenia and an increase in spondylarthritis, arthritis, inflammatory bowel disease, and thyroid disorders. One hundred thirty-nine participants (46%) were coinfected with HCV, with a steady decline throughout the study period. Only cryoglobulinemia was statistically associated with HCV infection. CONCLUSIONS AD increases over time in PWH with reasonable immune virological control. We observed a higher frequency of spondylarthritis, arthritis, autoimmune thyroid disorders, and inflammatory bowel disease in recent years.