Diffuse connective tissue disorders in HIV-infected patients

Abstract

Background: Human immunodeficiency virus (HIV) infection has been associated with various autoimmune disorders. Aim: To review the spectrum of diffuse connective tissue disorders (dCTD) in HIV-infected patients, in the context of highly active anti-retroviral therapy. Methods: Electronic search of the literature was performed using the terms HIV, AIDS, autoimmune, rheumatic/rheumatological, immune reconstitution inflammatory syndrome, Systemic Lupus Erythematosus, Diffuse Infiltrative Lymphocytosis Syndrome, Sjogren's syndrome, vasculitis, Behçet's disease, cryoglobulins, Henoch-Schönlein purpura, and antiphospholipid syndrome. Results: We reviewed the clinical manifestations, natural history and treatment of dCTDs, since the implementation of Highly Active Anti-Retroviral Therapy (HAART), and the emergence of new pathogenic mechanisms, such as the immune reconstitution inflammatory syndrome. Conclusions: Caution in differentiating clinical and laboratory findings of dCTDs from non-specific manifestations of acute and chronic HIV infection is warranted due to the common presentation. Patients with chronic infection and access to HAART have a normal life expectancy and dCTDs, although rare, must be correctly addressed. HAART alone or combined with immunosuppressive therapy result in favourable outcomes.

HIV-Associated Systemic Sclerosis: Literature Review and a Rare Case Report

“…HAART may act as a double-edged sword. It may diminish the autoimmune episode by restoring the dysregulated immune function [ 4 ]. It may also provoke the exacerbation of a latent autoimmune disorder or may trigger a new autoimmune disease’s onset during the immune restoration inflammatory syndrome (IRIS), simulating a delayed hypersensitivity reaction to a foreign or self-antigen [ 4 ].…”

Mediterranean Journal of Rheumatology September 2018 Highlights

“…In their review, Christoforidou and Galanopoulos provide an overview of diffuse connective tissue disorders in human immunodeficiency virus (HIV)-infected individuals. 4 The Authors underline the need for increased awareness in interpreting clinical and laboratory findings in these patients. Clinicians dealing with these patients must be able to discriminate actual rheumatological disorders from non-specific manifestations of acute and chronic HIV infection.…”