Abstract: 【Abstract】 Objective To evaluate the clinical efficacy and safety of secukinumab in the treatment of moderate-to-severe plaque psoriasis complicated by human immunodeficiency virus （HIV） infection. Methods Patients with moderate-to-severe plaque psoriasis complicated by HIV infection were enrolled from the Department of Dermatology and Venereology, Beijing Ditan Hospital, Capital Medical University from October 2021 to December 2024. All patients received subcutaneous injections of secukinumab at a dose of 150 or 300 mg once weekly from week 0 to 4, followed by every-4-week dosing thereafter. The Psoriasis Area and Severity Index （PASI） score and Dermatology Life Quality Index （DLQI） were assessed at weeks 0 （baseline）, 4, 12, 24, and 48. The proportions of patients achieving ≥ 75% and ≥ 90% improvements in PASI scores （PASI75, PASI90, respectively） from baseline were calculated, and adverse reactions were recorded. Results Ten patients completed the 48-week treatment, all of whom were males, aged 27 ? 44 years, with a baseline PASI score of 18.4 ± 4.9 points. At weeks 4, 12, 24, and 48, the PASI improvement rates （mean ± standard deviation） were 78.9% ± 11.1%, 91.4% ± 7.5%, 95.2% ± 4.2%, and 98.1% ± 2.1%, respectively; 7, 9, 10, and 10 patients achieved PASI75, and 1, 7, 8, and 10 patients achieved PASI90 at the above corresponding time points, respectively. Meanwhile, the DLQI score decreased from 21.6 ± 3.1 points at baseline to 1.0 ± 0.9 points at week 48. During treatment with secukinumab, all patients received regular and continuous antiretroviral therapy, with CD4? T-cell counts stable （> 200 cells/μl） and HIV viral loads consistently below 50 copies/ml. One patient experienced a mild adverse event （atopic dermatitis）, which resolved after symptomatic treatment; no treatment discontinuation or opportunistic infections occurred. Conclusions Secukinumab demonstrated rapid onset of action, significant overall efficacy, and favorable treatment adherence in HIV-positive patients with plaque psoriasis who were receiving antiretroviral therapy and maintained sustained virological suppression. Moreover, no adverse effects on HIV infection status were observed.

Key words: Psoriasis, HIV infections, Secukinumab, Therapy, Efficacy, Safety