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Rheumatology Advance Access originally published online on April 15, 2008
Rheumatology 2008 47(7):952-959; doi:10.1093/rheumatology/ken132
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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Rheumatic conditions in human immunodeficiency virus infection

U. A. Walker, A. Tyndall and T. Daikeler

Department of Rheumatology, Basel University, Basel, Switzerland.

Correspondence to: U. A. Walker, Department of Rheumatology, Basel University, Basel, Switzerland. E-mail: ulrich.walker{at}fps-basel.ch


  Abstract

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-{alpha} 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.

KEY WORDS: Acquired immunodeficiency syndrome, Anti-retroviral therapy, Arthritis, Human immunodeficiency virus, Psoriasis, Rheumatic diseases, Vasculitis

Submitted 11 December 2007; revised version accepted 4 March 2008.
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