Carpal tunnel syndrome in HIV patients?

Abstract

A wide range of rheumatic and peripheral nervous system disorders may develop in patients with HIV infection , leading to pain, sensory symptoms, and muscle weakness. Over the past three decades, the progress in management of HIV disease with anti-retroviral therapy (ART) has resulted in increased life expectancy for people living with HIV disease. With this new chronicity of the disease has a constellation of chronic musculo-skeletal, orthopaedic and rheumatic manifestations has emerged, as potential complications of the disease itself and/or the results of ART treatment regimen and/or because of expected age-related symptoms/manifestations. The incidence of CTS in the general population is around 3.8% with clinical examination and, when electroneu-romyography is used, it is 2.7%. In the HIV-positive population, the incidence is very close to that of the general population. The aim of this study was to evaluate the incidence of CTS and to identify factors influencing the development of CTS in HIV-infected patients attending our clinic. This syndrome has been associated with advanced HIV disease and the use of ART possibly due to an increased inflammatory state and the presence of concurrent HCV infection.

Osteoarticular complications related to HIV infection and highly active antiretroviral therapy

“…The occurrence of carpal tunnel syndrome has been reported among the osteoarticular changes observed in HIV/ AIDS patients receiving therapy, although the existing reports question its higher incidence in these patients compared with the general population [17,18]. Incidence in the general population was found to be around 3.8% during clinical evaluation and around 2.7% when electroneuromiography was used.…”

“…Other factors are associated with the development of this syndrome in HIV/AIDS patients, such as labor activities, hypothiroidism, hyperglicemia, rheumatoid arthritis, obesity and miscellaneous metabolic disorders. Therefore, direct correlation with the presence of HIV and antiretroviral therapy is still controversial [17,18].…”

Physical Activity and Exercise for People with Human Immunodeficiency Virus

“…In these individuals, the pattern of disease progression is accelerated compared with persons who are not infected by the virus [54,55]. Physical activity is recommended for fitness maintenance which can be achieved with motion physiotherapy.…”

Alterações ortopédicas na AIDS

“…Na população HIV-positiva, a incidência manteve-se muito próxima daquela da população geral (16,17) . Essa síndrome tem sido relacionada com o uso de TARV, especialmente com os IPs, e seria decorrente dos distúrbios metabólicos já conhecidos e depósito de material mixedematoso no túnel do carpo, com a consequente compressão nervosa.…”

“…Outros fatores são associados ao desenvolvimento dessa síndrome nos pacientes portadores de HIV/AIDS, como atividades profissionais, hipotireoidismo, hiperglicemia, artrite reumatoide, obesidade e distúrbios metabólicos variados. Portanto, a correlação direta com a presença do HIV e o TARV ainda é questionável (16,17) . O tratamento baseia-se no estadiamento da síndrome compressiva.…”