Prevalence of and risk factors for gout in HIV-positive adults: A case–control study

Abstract

Gout is the most common inflammatory arthritis worldwide. Its principal risk factor is hyperuricaemia. While gout has been described in HIV patients and numerous more outdated anti-retroviral therapies (ARTs) have been implicated, there have been few recent studies. Our case–control study investigated the prevalence of and risk factors for gout in an established HIV cohort. Cases were identified from database searches using key search terms, with two age- and gender-matched controls. These were compared for demographic factors, co-morbidities, HIV factors and ART exposure. Forty-five cases with gout were identified (point prevalence 2.2%). All were male and were more likely than controls to be of black African origin. Hypertension was associated with an almost five-fold increased gout risk (OR 4.8, 95% CI 1.8–12.4). No individual drug or ART class was associated with gout in this study but exposure to non-nucleoside reverse transcriptase inhibitors had a significantly protective effect against the risk of gout (OR 0.3, 95% CI 0.1–0.9). Our data suggest that gout is common in HIV patients and that the traditional risk factors, especially hypertension, play a key role. Gout and hyperuricaemia should be regarded as a biomarker of cardiovascular disease in HIV patients as they are in the general population.

HIV-Associated Rheumatic Diseases

“…38 However, new studies reveal that gout in HIV-infected people is not associated with HAART and that nonnucleoside reverse transcriptase inhibitors may even protect against gout (odds ratio, 0.3; 95% confidence interval, 0.1-0.9). 38 Most gout cases in HIV-infected patients are linked with traditional risk factors including hypertension, male sex, and African American race.…”

“…Gout is the most common inflammatory arthritis across the world. Prior literature suggested a strong association between HIV-infected people and gout thought to be due to early antiretroviral therapies linked to lipodystrophy and dyslipidemia 38 . However, new studies reveal that gout in HIV-infected people is not associated with HAART and that nonnucleoside reverse transcriptase inhibitors may even protect against gout (odds ratio, 0.3; 95% confidence interval, 0.1–0.9) 38 .…”

“…Prior literature suggested a strong association between HIV-infected people and gout thought to be due to early antiretroviral therapies linked to lipodystrophy and dyslipidemia 38 . However, new studies reveal that gout in HIV-infected people is not associated with HAART and that nonnucleoside reverse transcriptase inhibitors may even protect against gout (odds ratio, 0.3; 95% confidence interval, 0.1–0.9) 38 . Most gout cases in HIV-infected patients are linked with traditional risk factors including hypertension, male sex, and African American race.…”

Serum uric acid and high-sensitivity C-reactive protein levels among people living with HIV on dolutegravir and ritonavir-boosted atazanavir-based antiretroviral therapy: a comparative cross-sectional study

“…Hyperuricemia was increasingly seen among people living with HIV on ART than in the general population, which indicates people living with HIV are at greater risk of cardiovascular disease (CVD) than HIV-negative people, which means attention must be given to these people to prevent CVD ( 20 ). An increased risk of having hyperuricemia was seen among treatment-naive compared to treatment experienced people living with HIV ( 21 , 22 ). It is observed that hyperuricemia was also detected in HIV patients taking HAART ( 23 , 24 ).…”

Current issues in the management of patients with HIV infection and rheumatic diseases

“…Развитие подагры также не является редкостью, поскольку не только длительно персистирующая ВИЧ-инфекция, но и развивающиеся при СПИД онкологические заболевания, а также проведе-ние АРВТ нередко способствуют значительному повышению уровня мочевой кислоты (МК) [9]. Напротив, применение ненуклеозидных ингибиторов обратной транскриптазы для лечения ВИЧ снижает риск гиперурикемии [10].…”