Development of Ulcerative Colitis in a Patient With Human Immunodeficiency Virus

The relationship between the human immunodeficiency virus (HIV) and inflammatory bowel disease (IBD) is poorly understood. The coexistence of the two conditions is uncommon with scattered retrospective studies in the literature. Whereas HIV was initially thought to propagate IBD flares and increase disease severity, more studies are coming out showing that HIV may actually be protective against IBD development and relapse, particularly due to the depletion of CD4 lymphocytes. We present a HIV-positive female with new onset ulcerative colitis at the age of 42. Her HIV was poorly controlled for 25 years but with new gastrointestinal symptoms for 9 months, an endoscopic evaluation was done which revealed a new inflammatory bowel disease diagnosis, which warranted immediate therapy. In describing this patient's case, we discuss the uncommon coexistence of HIV and IBD and investigate potential relationships between the two conditions.