Human Immunodeficiency Virus-Associated Rheumatic Disorders in the HAART Era

Javier Marquez, Carlos Santiago Restrepo, Liliana Candia, Alberto Berman, Luis R. Espinoza

Research output: Contribution to journalArticle

55 Scopus citations

Abstract

Objective. To define the frequency and characteristics of human immunodeficiency virus (HIV)-associated rheumatic manifestations in patients receiving highly active antiretroviral therapy (HAART) referred to a rheumatology clinic. Methods. A total of 75 patients with HIV infection receiving HAART were prospectively evaluated for the presence of rheumatic complaints. Diagnosis of HIV infection was performed by ELISA and confirmed by Western blot, and all HIV patients were classified according to the US Centers for Disease Control criteria. Results. Seventy-five individuals with HIV infection and musculoskeletal manifestations were evaluated: 65 (86%) men and 10 (14%) women. Mean age was 32 ± 4.5 years (range 21-58). The group included 40 (53%) heterosexuals, 30 (40%) intravenous drugs users, 9 (12%) homosexuals, 3 (4%) who had received blood transfusion, and 2 (2.6%) with unknown risk factors. Septic manifestations were the most common complications seen in 31 (41%) out of 75, and included septic arthritis, cellulitis, osteomyelitis, diskitis, and pyomyositis. Fibromyalgia was present in 13 (17%), seronegative symmetric polyarthritis in 4, oligoarthritis in 4, psoriatic arthritis in 2, carpal tunnel syndrome in 2, and enthesitis in 2. Mutifocal bone non-Hodgkin's lymphoma was present in 7 (9.3%) and Kaposis's sarcoma of bone in 2 (2.6%) patients. Hypertrophic osteoarthropathy in 3 (4%) and aseptic bone necrosis of multiple bones was seen in 3 (4%) patients. Ten patients exhibited only arthralgias. Most patients had moderately elevated erythrocyte sedimentation rate and C-reactive protein. Mean CD4 cell count was 250 mm 3 (range 20-450), and mean HIV viral load was 5210 (range 0-75,300) copies/ml. Conclusion. Rheumatic manifestations were highly frequent in HIV patients receiving HAART referred to a rheumatology clinic, although the clinical spectrum differed from the pre-HAART era with septic and malignant complications being the most common manifestations seen.

Original languageEnglish (US)
Pages (from-to)741-746
Number of pages6
JournalJournal of Rheumatology
Volume31
Issue number4
StatePublished - Apr 1 2004
Externally publishedYes

Keywords

  • Arthritis
  • HIV
  • Haart
  • Kaposi's sarcoma
  • Septic arthritis
  • Tropical pyomyositis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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  • Cite this

    Marquez, J., Restrepo, C. S., Candia, L., Berman, A., & Espinoza, L. R. (2004). Human Immunodeficiency Virus-Associated Rheumatic Disorders in the HAART Era. Journal of Rheumatology, 31(4), 741-746.