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Rheumatology Advance Access published online on April 12, 2005
Rheumatology, doi:10.1093/rheumatology/keh636
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received October 13, 2004
Accepted March 8, 2005

Original Papers

Arthritis in association with human immunodeficiency virus infection in Black African children: causal or coincidental?

K. Chinniah 1*, G.M. Mody 2, R. Bhimma 1, and M. Adhikari 1

1 Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, University of KwaZulu Natal, Private Bag X7, Congella, 4013, South Africa
2 Department of Rheumatology, Nelson R. Mandela School of Medicine, University of KwaZulu Natal, Private Bag X7, Congella, 4013, South Africa

* To whom correspondence should be addressed.
K. Chinniah, E-mail: chinniahk2{at}ukzn.ac.za


  Abstract

Objectives. To compare human immunodeficiency virus (HIV)-infected and HIV-uninfected children with arthritis of unknown origin to determine whether the association between HIV infection and arthritis is causal or coincidental.

Method. Retrospective review of 132 children with arthritis who were tested for HIV infection.

Results. Thirty-five (27%) of the children were HIV infected and the male to female ratio was 2.5:1 (P = 0.02). Arthritis was the presenting feature of HIV infection in 78% of these children. The remaining 97 (73%) were diagnosed as having juvenile idiopathic arthritis. ‘Spondyloarthropathy-like’ features were found in 34% of HIV-infected children compared with 5% of uninfected children.

Conclusion. The high prevalence of HIV infection in 27% of children, the predominance of males and the increased prevalence of ‘spondyloarthropathy-like’ features, supports a causal relationship between HIV infection and arthritis.

Keywords: Arthritis; Juvenile idiopathic arthritis (JIA); Spondyloarthropathy (SPA); HIV infection; Children.
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