Rheumatic manifestations of human immunodeficiency virus infection

Abstract

Various rheumatic syndromes have been recognized in HIV-infected patients, including noninfectious inflammatory arthropathies, musculoskeletal infections, vasculitides, lupus-like syndrome, polymyositis, diffuse infiltrative lymphocytosis syndrome, and other uncommon rheumatologic conditions. Highly active antiretroviral therapy has caused dramatic changes in natural history, long-term outcome, morbidity and mortality in these patients. This is associated with the introduction of immune reconstitution inflammatory syndrome, particularly sarcoidosis, increased incidence of septic complications, and declining incidence of diffuse infiltrative lymphocytosis syndrome.

Rheumatic Diseases in HIV-Positive Patients in Kara (Togo)

“…All the same, the treatment of this inflammatory rheumatism remains a challenge dominated by the interactions between theART and the immunosuppressive treatment [20,21]. Unlike the West, where they appear as frequently associated with HIV and its treatment [22][23][24][25][26], no case of connectivity and vasculitis was found in our study.The rarity of these affections in the black race would be the main reason. The osteonecrosis are therefore now associated with HIV and/or with its treatment [9,[27][28][29] and they tend to be bilateral in our study.…”

Musculoskeletal Infections in Human Immunodeficiency Virus

“…Bones, as well as joints or striated muscle [5][6][7][8] can be affected. Infections may affect peripheral joints, spine, long bones or muscles.…”

The Scourge of HIV Infection in Sub-Saharan Africa — A Rheumatological Perspective

“…Since the first report of HIV-associated reactive arthritis almost a quarter of a century ago 2 , a wide spectrum of HIV-related rheumatic syndromes have been reported 3 . Many of the syndromes have clinical features that overlap with those of the more classical rheumatic disorders.…”

“…Possible explanations are cross-reactivity between the virus and autoantigen 3 and nonspecific polyclonal hypergammaglobulinemia due to B cell activation 9 . The authors conclude that although the anti-CCP antibodies can occur with advanced HIV disease, it has a better specificity for RA than RF.…”

“…An emerging problem is that of HAART-related rheumatic complications, ranging from immune reactivation inflammatory syndromes, e.g., sarcoidoisis, to bone disorders like osteoporosis and osteonecrosis (ON) 3 . As more patients receive HAART, the burden of ON from pain and physical disability is likely to put further strain on limited health resources in most of sub-Saharan Africa and where there is very limited access to arthroplasty surgery.…”