Musculoskeletal and rheumatological disorders in HIV infection: Experience in a tertiary referral center

Abstract

Background:Musculoskeletal involvement in human immunodeficiency virus (HIV) infected patients are important disease manifestations, responsible for increased morbidity and also decreased quality of life.Objectives:To study the spectrum of different musculoskeletal involvement in HIV infected patients and its impact on quality of life.Patients and Methods:Three hundred (n = 300) HIV-1 reactive patients were evaluated in respect to different musculoskeletal involvement including the quality of life from January 2010 to January 2011.Results:Male to female ratio was 11:1 with a mean age of 35 (±6.4) years and mean duration of the disease was 3 (±1.54) years. Majority of cases were truck drivers, motel workers, and jewelry workers. Musculoskeletal disorders were observed in a total of 190 cases (63.33%). The spectrum of musculoskeletal involvement was: Body ache in 140 (46.7%), arthralgia in 80 (26.7%), mechanical low back pain in 25 (8.3%), osteoporosis in 20 (6.7%), painful articular syndrome in 10 (3.3%), hypertrophic osteoarthropathy in two (0.7%), pyomyositis in two (0.7%), osteomyelitis in one (0.3%), and avascular bone necrosis in one patient (0.3%). Rheumatologic disorders associated were: Reactive arthritis in seven (2.3%), fibromyalgia in four (1.3%), septic arthritis in three (1%), acute gout in three (1%), spondyloarthropathy in two (0.7%), rheumatoid arthritis in two (0.7%), dermatomyositis in one (0.3%), and systemic lupus erythematosus (SLE) in one patient (0.3%). But HIV associated arthritis and diffuse infiltrative lymphocytosis syndrome (DILS) were not detected. Most of the patients had decreased quality of life.Conclusions:Musculoskeletal involvement was common in HIV patients causing increased morbidity, so early detection and timely intervention is essential to improve quality of life.

Fibromyalgia: A Critical and Comprehensive Review

“…It has long been held that Lyme disease increases the risk of FMS, but a recent study showed that the incidence of FMS in patients with cultureconfirmed Lyme disease did not exceed that of the general population during long-term follow-up [405]. The results for other infectious agents also are far from consistent [403,406,407]. This suggests that, if infectious agents act as triggers for FMS at all, this process is relevant in a subset of patients only.…”

Joint damage in hiv positive patients

“…По этой причине наличие симметричного и в ряде случаев деструктивного полиартрита у больных ВИЧ-инфекцией нередко классифицировали как «ревматои-доподобный» артрит [32]. В эпоху ВААРТ стала общепри-знанной возможность наличия «истинного» РА у больных ВИЧ-инфекцией с частотой 0,1-5% [13,[33][34][35][36]. В ходе мультицентрового когортного исследования, выполнен-ного французскими авторами, выявлено 46 больных РА в сочетании с ВИЧ-инфекцией.…”

Septic arthritis in immunocompetent and immunosuppressed hosts

“…Musculoskeletal disorders in patients with HIV may be due to a direct effect of the virus, opportunistic infections, or noninfectious complications of HIV infection or its therapy [78,79]. Various conditions can be seen in the setting of HIV, including painful articular syndrome, reactive arthritis, HIV-associated arthritis, rheumatoid arthritis, hypertrophic osteoarthropathy, acute gout, avascular bone necrosis, septic arthritis, and osteomyelitis [80,81]. Similar to HIV-negative patients, septic arthritis occurring in HIV-infected patients is most commonly due to S. aureus [82,83].…”