Prevalence of Autoimmune Diseases in Individuals Living with HIV in Korea: A Nationwide Population-Based Study

Background and Objectives: Human immunodeficiency virus (HIV) infection is associated with immune dysregulation, which may influence the development of autoimmune diseases. However, population-based evidence on the prevalence of autoimmune diseases in individuals living with HIV remains limited, particularly in Asian populations. This study aimed to evaluate the prevalence of autoimmune diseases in individuals living with HIV in Korea using nationwide population-based data. Materials and Methods: We conducted a cross-sectional analysis using the Health Insurance Review and Assessment Service National Patient Samples from 2012 to 2015, including 4,851,064 individuals aged ≥15 years. HIV infection and autoimmune diseases were identified using ICD-10 codes. The prevalence of autoimmune diseases in individuals with HIV infection was compared with that in the general population. Antiretroviral therapy (ART) status was determined based on prescription records. Results: A total of 1023 individuals were identified with HIV infection, all of whom were receiving antiretroviral therapy. The overall prevalence of autoimmune diseases was 4.4% in males and 3.6% in females with HIV, without significant differences compared to controls. However, the prevalence of ulcerative colitis in males (p = 0.030) and of dermatomyositis in females (p = 0.011) was higher in individuals with HIV. Conclusions: Although the overall prevalence of autoimmune diseases was not significantly increased in individuals living with HIV, certain autoimmune diseases-particularly ulcerative colitis in men and dermatomyositis in women-showed a higher prevalence. As these findings were based on small case numbers, they should be approached with caution. The results are best regarded as hypothesis-generative observations that warrant further investigation rather than findings on which clinical practice should currently be based. Further research using large datasets is warranted to confirm these associations and clarify the underlying immunological mechanisms.