Rheumatic manifestations of human immunodeficiency virus infection (original) (raw)
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Rheumatic manifestations in 556 patients with human immunodeficiency virus infection
Seminars in Arthritis and Rheumatism, 1991
We studied in retrospect the rheumatic manifestations of 556 patients with human immunodeficiency virus (HIV) infection. Eighty percent were men. Eighty-six percent were intravenous drug abusers (IVDAs), 9% homosexual, 3% partners of high-risk persons having the infection, 0.4% hemophiliacs, and 2% had no known risk factors. We found rheumatic disorders in 63 (11%) patients. The most frequent findings were myalgias and/or arthralgias (4.5%; one patient had an inflammatory myopathy), skeletal infections (3.6%), and arthralgias (1.6%). Reiter's syndrome and seronegative arthritis were present only in 0.5%, and HIV-associated arthritis and vasculitis in 0.4%, respectively. Skeletal infec-
Human immunodeficiency virus-associated rheumatic disorders in the HAART era
The Journal of Rheumatology, 2004
The association between human immunodeficiency virus (HIV) infection and inflammatory musculoskeletal (MSK) disorders is well established 1-5. A wide spectrum of rheumatic conditions, including reactive arthritis (ReA), psoriatic arthritis (PsA), ankylosing spondylitis, undifferentiated seronegative spondyloarthropathy, polymyositis, vasculitides, septic arthritis, pyomyositis, fibromyalgia, avascular necrosis, and more recently osteoporosis has been described in association with HIV infection 6,7. The prevalence of these MSK manifestations varies greatly among the different studies, ranging from less than 1% to over 60%. This wide variability may be secondary to a number of factors including patient selection, ethnic background of the population under study, risk factors, stage of HIV infection, specific highly active antiretroviral therapy (HAART), and the design of the studies (prospective or retrospective) among others. Regarding the latter, it should be stated that most investigations of the association between HIV and MSK involvement were undertaken prior to the advent of HAART. The availability of HAART in the past several years has made a significant impact on the natural history, longterm prognosis, morbidity, and mortality of patients with HIV 8-10. Whether this therapeutic modality affects the expression of rheumatic manifestation associated with HIV infection has not been fully explored. Berman, et al 11 attempted, unsuccessfully several years ago, to establish whether or not the use of antiretroviral therapy alters the frequency or expression of rheumatic manifestations in HIV infected individuals. Our objective was to determine the frequency and clinical expression of rheumatic manifestations in HIVinfected individuals receiving HAART.
Evolving spectrum of HIV-associated rheumatic syndromes
Best Practice & Research Clinical Rheumatology, 2015
At the end of 2013, 35 million people worldwide were infected with HIV. The prognosis of HIV has been transformed by combination anti-retroviral therapy (cART). Providing compliance is good, use of cART has normalised the life expectancy of HIV-infected people leading to a growing population of people with chronic infection. Management of HIV patients has therefore needed to adapt in order to control viral activity but also manage long term complications of HIV and cART. Rheumatological manifestations of HIV were first described in 1989. Since, there have been case reports, case series, and epidemiological studies describing different clinical manifestations of HIV in the musculoskeletal system. This review will encompass musculoskeletal pain, fibromyalgia, systemic lupus erythematosus, and inflammatory arthritis in HIV. We will aim to report on the prevalence of these conditions and the risk factors, explore the impact of the virus on the clinical presentations and discuss implications for diagnosis and management.
Rheumatologic Manifestations of Infections with Human Immundeficiency Virus (HIV)
Purpose: To review the various rheumatologic manifestations of human immunodeficiency virus (HIV) infection and to discuss their potential pathogenic mechanisms. Data Identification: A literature search using MEDLINE (1981 to 88) and Index Medicus (1981 to 88) and review of references from all identified articles. Study Selection: All studies and case reports addressing arthritis, myopathies, vasculitis, the sicca syndrome, systemic lupus erythematosus, and autoimmune phenomena in HIV-infected patients are cited. Results of Data Synthesis: The Reiter syndrome and other reactive arthritides are the commonest arthritides seen in HIV-infected patients. Psoriatic arthritis and septic arthritis with opportunistic agents, as well as an articular pain that is severe, acute, and intermittent, may also occur with HIV infection. An arthritis that may be specific for the acquired immunodeficiency syndrome (AIDS) has been described. Myopathies, especially of a polymyositic type, vasculitis, and the sicca syndrome are also part of the spectrum of rheumatologic presentation of HIV infection. Several autoimmune phenomena, such as antinuclear and anticardiolipin antibodies, as well as lupus anticoagulant, have been reported in HIV-infected patients. Conclusions: The Reiter syndrome, reactive arthritis, polymyositis, and the sicca syndrome may herald the onset of clinically evident HIV infection. These diseases and others may also occur in patients with full-blown AIDS. Furthermore, HIV infection may mimic systemic lupus erythematosus.
Rheumatic Manifestations in HIV Positive Patients at Soetomo Hospital Indonesia
International Journal of Research Publications
Background: Rheumatic disease is one of the comorbidities that can occur in patients with Human Immunodeficiency Virus (HIV) infection. The prevalence and the spectrum of the diseases are varied in some previous studies. The emergence of rheumatologic diseases can increase morbidity and decrease the quality of life of HIV-positive patients. Purpose: This study aims to determine the variety of rheumatologic diseases that occur in HIV positive patients and the characteristics of the patients. Methods: This study is a descriptive study. Data obtained from the medical record of patients include the data sociodemographic, CD4 cell count, and history of antiretroviral drugs as well as the data from patient interviews. This study was carried out on 130 patients with HIV who were controlled at Dr. Soetomo Hospital, Surabaya, in the period of June 2019. Results: HIV-positive Patients were dominated by men (66 ,9%) with a mean age of 37.36 (±9.524). The patient's average CD4 cell count was 322.95 cells/mm3 (±145,523) and the most widely used drug combinations were tenofovir, lamivudine, and efavirenz (66.2%). Rheumatic manifestations were obtained in 25 of 130 (19.2%) with joint pain in 13 (10.0 %) cases, myalgia 4 (3.1%) cases, systemic lupus erythematosus 4 (3.1%) cases, osteomyelitis 2 (1.5%) cases, osteoarthritis 1 (0.8%) case, and spondylarthropathy 1 (0.8%) case. Conclusion: Several types of rheumatic manifestations were found in HIV-positive patients with arthralgia being the most common. Rheumatic manifestations commonly occur in adult men with low CD4 cell counts. Early detection and appropriate therapy related to rheumatic manifestations of HIV infection are expected to improve the patient's quality of life.
Clinical rheumatology, 2018
The aim of the study was to calculate the proportion of rheumatic diseases in HIV patients who were receiving ART and to identify association of the HIV medications with the development of rheumatologic diseases. We conducted a retrospective chart review during the period of 2010 to 2016. We identified 2996 patients as having chronic HIV infection and on ART, and we collected data regarding patient's demographic characteristics, comorbidities, CD 4 count, HIV viral load, and ART. One hundred thirteen out of 2996 HIV patients (3.8%) were found to have a rheumatic condition (mean age of 48.6 years, 83% male). The most frequent musculoskeletal condition was avascular necrosis (AVN) in 39 (1.3%), and the most frequent autoimmune condition was psoriasis in 28 patients (1%). Compared with the 200 HIV patients without any diagnosis of rheumatic disease were the older patients with rheumatic conditions (mean age of 48.9 vs. 42.7 years; p < 0.01), and had a longer duration of HIV infe...
[Human immunodeficiency virus infection and rheumatology]
Vnitrni lekarstvi, 1990
The most important rheumatologic manifestations associated with infection with human immunodeficiency virus are described. Among arthritides, Reiter's syndrome, psoriatic arthritis, and some forms of reactive arthritis are the most common. Arthralgias are also relatively frequent. Manifestations of polymyositis, vasculitis and sicca syndrome with a relatively broad spectrum of various autoimmune phenomena are also very important. The author emphasizes the importance of interdisciplinary cooperation of internists, rheumatologists, infectionists and virologists in solving questions associated with laboratory and clinical aspects of the relationship between rheumatologic manifestations and infection with human immunodeficiency virus.
Rheumatoid arthritis in patients with HIV: management challenges
Open Access Rheumatology: Research and Reviews, 2016
Over the past few decades, HIV has been transformed from a once-uniformly fatal disease to now a manageable but complex multisystem illness. Before highly active antiretroviral therapy (HAART), reports suggested that HIV-infected patients with rheumatoid arthritis (RA) would experience remission of their disease. It has now become clear that RA can develop in HIV-infected patients at any time, independent of HAART. Choosing the right medication to treat symptoms related to RA while avoiding excess weakening of the immune system remains a clinical challenge. Agents such as hydroxychloroquine and sulfasalazine might best balance safety with efficacy, making them reasonable first choices for therapy in HIV-infected patients with RA. More immune suppressing agents such as methotrexate may balance safety with efficacy, but data are limited. Corticosteroids such as prednisone may also be reasonable but could increase the risk of osteonecrosis. Among biologic response modifiers, tumor necrosis factor α inhibitors may balance safety with efficacy, but perhaps when HIV replication is controlled with HAART. Monitoring RA disease activity remains challenging as only one retrospective study has been published in this area. Those with HIV infection and RA can experience comorbidities such as accelerated heart disease and osteoporosis, a consequence of the chronic inflammatory state that each illness generates. Although HIV-infected patients are at risk for developing the immune reconstitution inflammatory syndrome when starting HAART, it appears that immune reconstitution inflammatory syndrome has a minimal effect on triggering the onset or the worsening of RA.