Reactivation of chronic haematogenous osteomyelitis in HIV-infected patients

Abstract

Background: The aim of the study is to determine the prevalence of HIV infection among adult patients with reactivation of haematogenous chronic osteomyelitis. Methods: A retrospective analysis of prospectively collected data from 143 adult patients with chronic osteomyelitis. Results: A total of 143 patients were included in the study group, with a mean age of 38 years (range 14-78 years). Twenty-two per cent (n=31) of patients were diagnosed with reactivation of chronic haematogenous osteomyelitis, while 78% of patients had contiguous chronic osteomyelitis (29% [n=42] post-operative and 49% [n=70] post-traumatic, respectively). Forty (28%) patients were found to be HIV positive with a mean CD4 count of 414 cells/mm³ (range 13-1 034 cells/mm³). Twenty-four (60%) of patients with HIV were on antiretroviral therapy at time of diagnosis. The prevalence of HIV infection among patients with contiguous (post-operative or post-traumatic) infections was 32%, in comparison to 13% in the group with reactivation of chronic haematogenous infections (p=0.04; OR 3.2; 95% CI 1.0-9.8). Conclusion: The prevalence of HIV infection among patients with reactivation of chronic haematogenous osteomyelitis appeared to be lower than that seen in patients with chronic osteomyelitis from other causes and lower than that seen in the general population in South Africa.