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Joel M. Gelfand, MD; Donald Rudikoff, MD; Mark Lebwohl, MD; Mary E. Klotman, MD

Arch Dermatol. 1998;134:940-945.

Objective  To study the plasma human immunodeficiency virus type 1 (HIV-1) RNA levels of 12 patients seropositive for HIV who were undergoing UV-B phototherapy to determine if UV-B phototherapy up-regulates HIV activity in humans.

Design  A self-controlled prospective cohort of HIV-infected patients seen for the treatment of a skin disorder responsive to UV-B phototherapy. Viral levels were measured weekly for 8 weeks of phototherapy. Follow-up viral levels were measured for patients who continued phototherapy beyond 8 weeks, those who had a significant change in their viral level, or both.

Setting  Outpatient clinic of an academic hospital.

Patients  Patients with HIV disease and a skin disorder responsive to UV-B phototherapy. Inclusion criteria for patients in this study were those receiving a stable antiviral regimen for at least 6 weeks and who had no major illness or immunization in the 2 months before starting phototherapy. Of 72 patient volunteers screened, 15 met the criteria, 2 declined to participate, and 13 entered the study. One patient was dropped from the study because an accurate baseline measurement could not be obtained. Twelve patients were analyzed, 2 of whom left the study early, 1 at 6 weeks and 1 at 7 weeks.

Interventions  Ultraviolet-B phototherapy.

Main Outcome Measure  Plasma HIV-1 RNA viral level.

Results  Plasma HIV-1 RNA levels showed no significant increase or decrease in most of the patients, defined as a 3-fold change from baseline (mean fold change from baseline after 8 weeks of phototherapy,-1.1; 95% confidence interval, 2.9 to-5.0). Trend analysis indicated no significant pattern of change in viral levels (slope,-0.013 log; P >.25). The CD4⁺ cell counts also remained unchanged (mean before therapy, 277x10⁹/L; mean after therapy, 285x10⁹/L; P=.67).

Conclusion  No significant effect of UV-B exposure was seen on plasma HIV-1 levels.

From Harvard Medical School, Boston, Mass (Dr Gelfand), and the Departments of Dermatology (Drs Rudikoff and Lebwohl) and Internal Medicine (Dr Klotman), Mount Sinai School of Medicine, New York, NY.

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Barbara Z. Zmudzka and Janusz Z. Beer
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Ultraviolet Therapy and Patients With HIV Infection
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Arch Dermatol 1998;134:1025-1026.
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