Rheumatic conditions in human immunodeficiency virus infection

• Published in: Rheumatology (Oxford, England) Vol. 47; no. 7; pp. 952 - 959
• Main Authors: Walker, U. A., Tyndall, A., Daikeler, T.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.07.2008; Oxford Publishing Limited (England)
• Subjects: Acquired immunodeficiency syndrome; Anti-retroviral therapy; Antirheumatic Agents - therapeutic use; Antiviral Agents - adverse effects; Arthralgia - etiology; Arthritis; Arthritis - etiology; Biological and medical sciences; Bone Diseases - etiology; Dermatology; Diseases of the osteoarticular system; HIV Infections - complications; HIV Infections - drug therapy; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Muscular Diseases - etiology; Psoriasis; Psoriasis. Parapsoriasis. Lichen; Rheumatic diseases; Rheumatic Diseases - drug therapy; Rheumatic Diseases - etiology; Rheumatic Diseases - virology; Vasculitis; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Vasculitis; Psoriasis; Anti-retroviral therapy; Acquired immunodeficiency syndrome; Rheumatic diseases; Arthritis; Human immunodeficiency virus; Immunopathology; Skin disease; Diseases of the osteoarticular system; Rheumatology; Retroviridae; Cardiovascular disease; AIDS; Immune deficiency; Lentivirus; Infection; Vascular disease; Virus; Treatment; Viral disease; Rheumatism
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/ken132

Many rheumatic diseases have been observed in HIV-infected persons. We, therefore, conducted a comprehensive literature search in order to review the prevalence, presentation and pathogenesis of rheumatic manifestations in HIV-infected subjects. Articular conditions (arthralgia, arthritis and SpAs) are either caused by the HIV infection itself, triggered by adaptive changes in the immune system, or secondary to microbial infections. Muscular symptoms may result from rhabdomyolysis, myositis or from side-effects of highly active anti-retroviral therapy (HAART). Osseous complications include osteonecrosis, osteoporosis and osteomyelitis. Some conditions such as the diffuse infiltrative lymphocytosis syndrome and sarcoidosis affect multiple organ systems. SLE may be observed but may be difficult to differentiate from HIV infection. Some anti-retroviral agents can precipitate hyperuricaemia and are associated with arthralgia. When indicated, immunosuppressants and even anti-TNF-α agents can be used in the carefully monitored HIV patient. Thus, rheumatic diseases and asymptomatic immune phenomena remain prevalent in HIV-infected persons even after the widespread implementation of highly active anti-retroviral therapy.