Here we describe a case of a 39-year-old male with HIV and a 20-year history of generalized plaque psoriasis and psoriatic arthritis. The patient had been refractory to all treatments until initiating ustekinumab, the monoclonal antibody against IL-12/23. While using ustekinumab, the patient's CD4 T-cell count and HIV viral load have remained stable. Due to the questions surrounding the use of biologics in HIV-positive patients, we review the successful use of anti-TNF agents in patients with chronic HIV infection as well as the single other reported case of ustekinumab's use in an HIV-positive patient. We therefore begin to build the case for ustekinumab as an alternative biologic therapy for the HIV-infected psoriasis patient.
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