“…Furthermore, TNF-α is a pivotal mediator in granulomatous inflammation, generating concern about the use of anti-TNF-α in HIV patients, who often suffer from other comorbidities, including tuberculosis, hepatitis B and other opportunistic infections. In fact, etanercept, a soluble TNF-α receptor, has been effectively used, at a dosage of 25 or 50 mg, in patients with HIV-associated psoriasis or psoriatic arthritis [21,22], though one of the treated patients withdrew due to frequent bacterial infections, not definitely related to the biological [20]. It is of note, in all patients, that the CD4+ cell count remains stable, and in one of them viral load was undetectable after 20 weeks [22].…”