HIV-ASSOCIATED ARTHRITIS. Review and clinical cases
Article PDF (Українська)

Keywords

HIV infection, arthritis, musculoskeletal symptoms

Abstract views: 10
PDF Downloads: 8

How to Cite

Iaremenko , O., & Koliadenko , D. (2022). HIV-ASSOCIATED ARTHRITIS. Review and clinical cases. Medical Science of Ukraine (MSU), 18(1), 73-83. https://doi.org/10.32345/2664-4738.1.2022.10

Abstract

Relevance. HIV infection is characterized by a wide spectrum of clinical manifestations, including musculoskeletal symptoms, which can occur at any stage of the disease.

Objective: to analyze own clinical cases with rheumatologic manifestations of HIV infection in context of literature data on the spectrum of musculoskeletal manifestations of HIV infection, approaches to diagnosis and treatment.

Methods. Presentation of own clinical cases and review of scientific publications in the international electronic scientometric database PubMed using keywords «HIV infection», «arthritis», «musculoskeletal manifestations» over the period 2000-2021 years.

Results. The prevalence of musculoskeletal symptoms in HIV-infected individuals ranges from 10 to 45%. Articular manifestations of HIV infection can be divided into 3 main groups: 1) related to HIV (arthralgias, painful articular syndrome, HIV-associated arthritis, septic arthritis); 2) inflammatory arthritis (rheumatoid arthritis, reactive arthritis, psoriatic arthritis, undifferentiated spondyloarthritis); 3) associated with antiretroviral therapy (aseptic necrosis, osteoporosis, osteomalacia, immune reconstitution inflammatory syndrome, gout). For treatment of articular manifestations analgesics, nonsteroidal anti-inflammatory drugs (drug of choice - indomethacin), intraarticular or oral glucocorticoids, disease-modifying antirheumatic drugs (drug of choice - hydroxychloroquine) may be used. Conditions for initiation of therapy with disease-modifying antirheumatic drugs: a controlled steady course of HIV with antiretroviral therapy performed, the number of CD4+ cells >200/ml, undetectable viral load. Our clinical cases confirm that indications for HIV testing in rheumatologic patients are reactive arthritis of unknown etiology, atypical lupus, persistent leukopenia, unreasonable weight loss, lack of an adequate response to traditional therapy of rheumatological diseases.

Conclusions. Articular syndrome in HIV-infected individuals may be a separate manifestation of HIV infection and result of antiretroviral therapy. Treatment of articular manifestations in HIV-infected individuals primarily involves the treatment of HIV infection, and it depends on its clinical stage, use of antiretroviral therapy, the severity of articular syndrome and involvement of other organs. Our clinical observations demonstrate the possibility of articular manifestations at various stages of HIV infection: before diagnosis, during prolonged stable antiretroviral therapy, as well as after a change in antiretroviral therapy.

https://doi.org/10.32345/2664-4738.1.2022.10
Article PDF (Українська)

References

Mehsen-Cêtre N, Cazanave C. Osteoarticular manifestations associated with HIV infection. Joint Bone Spine. 2017;84(1):29-33. DOI: 10.1016/j.jbspin.2016.04.004

View at:

Publisher Site: https://www.sciencedirect.com/science/article/abs/pii/S1297319X16300550?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/27238195/

Mody GM, Parke FA, Reveille JD. Articular manifestations of human immunodeficiency virus infection. Best Practice & Research Clinical Rheumatology. 2003;17(2):265-287. DOI: 10.1016/S1521-6942(03)00003-2.

View at:

Publisher Site: https://www.sciencedirect.com/science/article/abs/pii/S1521694203000032?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/12787525/

Fox C, Walker-Bone K. Evolving spectrum of HIV-associated rheumatic syndromes. Best Practice & Research Clinical Rheumatology. 2015;29(2):244-258. DOI: 10.1016/j.berh.2015.04.019.

View at:

Publisher Site: https://www.sciencedirect.com/science/article/abs/pii/S1521694215000261?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/26362742/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759923/

Walker-Bone K, Doherty E, Sanyal K, Churchill D. Assessment and management of musculoskeletal disorders among patients living with HIV. Rheumatology (Oxford). 2017;56(10):1648-1661. DOI: 10.1093/rheumatology/kew418.

View at:

Publisher Site: https://academic.oup.com/rheumatology/article/56/10/1648/2738928

PubMed: https://pubmed.ncbi.nlm.nih.gov/28013196/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483171/

Van de Ven NS, Ngalamika O, Martin K, Davies KA, Vera JH. Impact of musculoskeletal symptoms on physical functioning and quality of life among treated people with HIV in high and low resource settings: A case study of the UK and Zambia. PLoS One. 2019;14(5):e0216787. DOI: 10.1371/journal.pone.0216787.

View at:

Publisher Site: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216787

PubMed: https://pubmed.ncbi.nlm.nih.gov/31083692/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513081/

Сuellar ML, Espinoza LR. Rheumatic manifestations of HIV-AIDS. Baillieres Best Pract Res Clin Rheumatol. 2000;14(3):579-93. DOI: 10.1053/berh.2000.0094.

View at:

Publisher Site: https://www.sciencedirect.com/science/article/abs/pii/S1521694200900949?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/10985987/

Yang JJ, Tsai MS, Sun HY, Hsieh SM, Chen MY, Sheng WH, Chang Sh-Ch. Autoimmune diseases-related arthritis in HIV-infected patients in the era of highly active antiretroviral therapy. Journal of Microbiology, Immunology and Infection. 2015;48(2):130-6. DOI: 10.1016/j.jmii.2013.08.002.

View at:

Publisher Site: https://www.sciencedirect.com/science/article/pii/S1684118213001473?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/24064287/

Adizie T, Moots RJ, Hodkinson B, French N, Adebajo AO. Inflammatory arthritis in HIV positive patients: A practical guide. BMC Infectious Diseases. 2016;16:100. DOI: 10.1186/s12879-016-1389-2.

View at:

Publisher Site: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-1389-2

PubMed: https://pubmed.ncbi.nlm.nih.gov/26932524/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4774153/

Walker UA, Tyndall A, Daikeler T. Rheumatic conditions in human immunodeficiency virus infection. Rheumatology (Oxford). 2008;47(7):952-9. DOI:10.1093/rheumatology/ken132.

View at:

Publisher Site: https://academic.oup.com/rheumatology/article/47/7/952/1789584

PubMed: https://pubmed.ncbi.nlm.nih.gov/18413346/

Parperis K, Abdulqader Y, Myers R, Bhattarai B, Al-Ani M. Rheumatic diseases in HIV-infected patients in the post-antiretroviral therapy era: a tertiary care center experience. Clin Rheumatol. 2019;38(1):71-76. DOI: 10.1007/s10067-018-4089-z.

View at:

Publisher Site: https://link.springer.com/article/10.1007/s10067-018-4089-z

PubMed: https://pubmed.ncbi.nlm.nih.gov/29619587/

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.