Autoimmune manifestations of human immunodeficiency virus (HIV) infection

The human immune deficiency virus (HIV) is not only capable of inducing a state of immunodeficiency, but it is also associated with a state of profound immune dysregulation. This immune dysregulation may manifest itself as autoimmune reactivity that may participate in the overall pathogenic process of HIV infection as well as in the development of a variety of autoimmune laboratory phenomena and clinical syndromes. If autoimmune mechanisms are operative in the immunopathogenesis of the virus itself in the form of autocytotoxicity, the knowledge of this is critically important for the development of effective forms of antiviral therapy. The recognition that individuals infected with HIV can develop a wide variety of autoimmune laboratory phenomena including hypergammaglobulinemia circulating immune complexes and autoantibodies is important to assist in the proper interpretation of tests. The development of clinical autoimmune syndromes in HIV-infected individuals, such as connective tissue disorders, immune cytopenias, and other conditions, is important to the clinician, who must recognize these alternative forms of disease presentation for accurate diagnosis and treatment.