Rheumatic manifestations of HIV infection

IntroductionHuman immunodeficiency virus (HIV) infection which is a global pandemic affecting millions of people shares many similarities with autoimmune diseases. In this study we share our experience in a HIV referral service hospital.ObjectivesTo study the rheumatologic disorders encountered in HIV infected patients.MethodsThe study was carried out between July 2002 and December 2005 in an armed forces referral centre for HIV cases. All HIV cases reporting to the centre were screened for rheumatic disorders six monthly during the study period. CD4 count was done in all cases from 2004 onwards once a year.ResultsAbout 704 HIV cases were studied during this period. Of these 469 cases were newly detected. Mean duration of the disease among the remaining 235 old cases was 3.6 years (range 1–11 years). 126 patients were on highly active retroviral therapy (HAART). About 30% of the newly detected patients were asymptomatic and were diagnosed during blood donation or voluntary HIV testing. Twenty-eight patients expired during study period. Rheumatic disorders were diagnosed in 14 cases (2%). Two patients presented with inflammatory arthritis. Seronegative spondyloarthropathy was the commonest presentation. There were no cases of vasculitis or polymyositis in our study. Non-specific systemic symptoms of fatigue, myalgia and polyarthralgia seen in HIV infection or opportunistic infections were not considered rheumatic disorder after relevant investigations.ConclusionThough there are many reports of increased incidence of reactive arthritis and other rheumatic disorders in HIV infection, our series consisting mainly adult males, showed only 2% prevalence of rheumatic disorders in HIV infection.