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 1,023 individuals were identified with HIV infection, all of whom were receiving antiretroviral therapy. The overall prevalence of autoimmune diseases was 4.37% in males and 2.38% in females with HIV, without significant differences compared to controls. However, the prevalence of Behçet’s disease, ulcerative colitis, and primary biliary cholangitis was significantly higher in males with HIV (P < 0.05), while dermatomyositis was significantly more prevalent in females with HIV (P < 0.001). Conclusions: Although the overall prevalence of autoimmune diseases was not significantly increased in individuals living with HIV, specific autoimmune diseases showed higher prevalence in this population. These findings suggest that clinicians should consider autoimmune dis-eases in the differential diagnosis of patients with HIV and highlight the need for further research on underlying immunological mechanisms.