Arthritis in childhood human immunodeficiency virus infection predominantly associated with human leukocyte antigen B27

Suri, Deepti; Sharma, Avinash; Bhattad, Sagar; Rawat, Amit; Arora, Sunil; Minz, Ranjana Walker; Singh, Surjit

doi:10.1111/1756-185x.12947

Cited by 5 publications

(2 citation statements)

References 22 publications

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“…There are only a few studies worldwide on musculoskeletal manifestations involving pediatric population with HIV (10–14). One recent single-center case series from northern India has reported four children with HIV infection who developed arthritis (32). So, the index study is the first large-scale prospective study of its kind to address the spectrum of rheumatological manifestations in children infected with HIV.…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal manifestations in pediatric patients infected with human immunodeficiency virus: Developing country perspective

Chakladar¹,

Mondal²,

Sabui³

et al. 2019

Eur J Rheumatol

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Objective Musculoskeletal manifestations in children infected with human immunodeficiency virus (HIV) are responsible for increased morbidity and decreased quality of life. Even in this era of highly active anti-retroviral therapy (HAART), there are limited studies on different rheumatological manifestations in pediatric patients with HIV, and the spectrum of musculoskeletal manifestation in pediatric HIV is yet to be established. Methods A single-center, prospective, observational study was carried out from October 2014 to September 2016 in a tertiary care hospital of Eastern India with 517 children infected with HIV aged between 3 and 19 years. Particulars of musculoskeletal involvement were at first screened with pediatric gait, arm, leg, spine (pGALS) screening protocol, followed by detailed examination in patients identified through screening. All the participants were re-examined at three and six months of follow-up. Results Musculoskeletal manifestations were found in 11.2% of the study population. The most common non-infective manifestation found in the study population was arthralgia (5.22%), followed by myalgia (3.29%). The prevalence of definite arthritis was found to be 6/1000 children, whereas infective manifestations (including arthritis, myositis, and osteomyelitis) were found in 2.12% of study population. Musculoskeletal manifestations were commonly found in children infected with HIV who were on anti-retroviral drugs. These manifestations were found commonly in the children in the second decade of their lives. Malnutrition, advanced stage of HIV infection (WHO clinical stage 4), lower CD4 count at the time of evaluation, and longer duration of disease were associated with increased frequency of musculoskeletal manifestations. Conclusion Musculoskeletal manifestations are frequent in pediatric population infected with HIV. But for better delineation, further multicentric studies are warranted in future in children infected with HIV.

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Section: Discussionmentioning

confidence: 99%

Musculoskeletal manifestations in pediatric patients infected with human immunodeficiency virus: Developing country perspective

Chakladar¹,

Mondal²,

Sabui³

et al. 2019

Eur J Rheumatol

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“…A case series of musculoskeletal manifestations in HIV-infected children in India reported 3 cases of inflammatory arthritis, all of which occurred in older girls with advanced immunosuppression ( 60 ). Another report from India described a single case of HIV arthropathy, and three cases of HLA-B27-associated arthritis in HIV-infected children ( 61 ). A study of juvenile idiopathic arthritis from Zambia reported 7 cases of arthritis in HIV-infected children, but did not provide details of subgroup analysis ( 62 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical Features of HIV Arthropathy in Children: A Case Series and Literature Review

2021

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BackgroundHIV infection has been associated with a non-erosive inflammatory arthritis in children, although few published reports exist. This study describes the clinical, laboratory and imaging features of this noncommunicable disease in a series of HIV-infected children in South Africa.MethodsA database search was conducted to identify HIV-infected children enrolled in a Paediatric Rheumatology service in Cape Town, South Africa between 1 January 2010 and 31 December 2020. Retrospective data were collected from individuals classified with HIV arthropathy, based on a predefined checklist. Demographic, clinical, laboratory, sonographic, therapeutic, and outcomes data were extracted by chart review. Descriptive statistical analysis was performed using R (v4.0.3).ResultsEleven cases of HIV arthropathy were included in the analysis. Cases predominantly presented in older boys with low CD4+ counts. Median age at arthritis onset was 10.3 years (IQR 6.9 – 11.6) and the male-female ratio was 3.0. The median absolute CD4+ count was 389 cells/uL (IQR 322 – 449). The clinical presentation was variable, with both oligoarthritis and polyarthritis being common. Elevated acute phase reactants were the most consistent laboratory feature, with a median ESR of 126 mL/h (IQR 67 – 136) and median CRP of 36 mg/L (IQR 25 – 68). Ultrasonography demonstrated joint effusions and synovial hypertrophy. Response to therapy was slower than has generally been described in adults, with almost all cases requiring more than one immunosuppressive agent. Five children were discharged in established remission after discontinuing immunotherapy, however outcomes data were incomplete for the remaining six cases.ConclusionsIn this case series, HIV arthropathy was associated with advanced immunosuppression. Therapeutic modalities included immunomodulators and antiretroviral therapy, which consistently induced disease remission although data were limited by a high rate of attrition. Prospective studies are needed to define and understand this HIV-associated noncommunicable disease.

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Rheumatological Manifestations of HIV Infection

Chinniah¹

2020

HIV Infection in Children and Adolescents

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Arthritis in childhood human immunodeficiency virus infection predominantly associated with human leukocyte antigen B27

Abstract: Aim: Children with human immunodeficiency virus

Cited by 5 publications

References 22 publications

Musculoskeletal manifestations in pediatric patients infected with human immunodeficiency virus: Developing country perspective

Musculoskeletal manifestations in pediatric patients infected with human immunodeficiency virus: Developing country perspective

Clinical Features of HIV Arthropathy in Children: A Case Series and Literature Review

Rheumatological Manifestations of HIV Infection

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