Background: Treatment by ultraviolet radiation (UV) during human immunodeficiency virus (HIV) infection is controversial, since exposure of HIV-infected cells in vitro to UV enhances HIV replication in vitro. Methods: Four consecutive AIDS patients with psoriasis and CD4 count lower than 20/mm3, were treated with 8-methoxypsoralen and UVA (PUVA). HIV viremia expressed as log of HIV-1 RNA copies/ml of plasma was quantified 10 min before and 1 h following UVA exposure, every week during PUVA therapy and at the end of treatment. The Psoriasis Area Surface Index (PASI) score was used to quantify the severity of psoriasis. Results: No significant change in HIV-1 RNA level was observed in the 18 paired samples analyzed before and 1 h after PUVA (median: ––0.05 log HIV-1 RNA, range: ––0.50––0.21, p = 0.10). After 12–31 UVA exposure for a total dose of 15.5–196 J/cm2 over a period of 6–15 weeks, viremia changes from baseline in the 4 patients were ––0.61 ––0.07, 0.36 and 0.39 log HIV RNA. In 1 patient without antiviral treatment, a persistent decrease in viremia and transient increase in CD4 cell count were observed. PUVA was well tolerated and associated with significant improvement of the PASI score in 3 patients. Conclusion: HIV viremia is not significantly modified by PUVA therapy in AIDS patients with psoriasis.
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