title: HIV infection as a risk factor for septic arthritis.
abstract: We prospectively studied the demographics, the clinical and diagnostic features, the HIV-1 serostatus and the therapeutic response for all new patients with septic arthritis (SA) admitted to the Department of Internal Medicine of the Centre Hospitalier de Kigali, Rwanda, over a 19 month period. SA was diagnosed in 24 patients (10 male, 14 female), of whom 19 (79%) were HIV-1 seropositive (HIVpos). Gonococcal arthritis was found in four patients, all HIVpos. Non-gonococcal bacterial arthritis was established in 16 patients, of whom 13 were HIVpos. Causative organisms involved in this group and the corresponding HIV-1 serostatus of the patients were: Staphylococcus aureus: 4; 2 HIVpos. 2 HIVneg: Streptococcus pneumoniae: 4; 4 HIVpos; Salmonella group B: 2; 2 HIVpos; Streptococcus group D: 1; 1 HIVpos; Klebsiella pneumoniae: 1; 1 HIVpos; undetermined: 4; 3 HIVpos; 1 HIVneg. Tuberculous arthritis was presumed in four patients, of whom two were HIVpos. HIV-1-associated SA had a classical acute presentation and an overall good prognosis Compared to a control group consisting of hospitalized patients with malaria as the sole diagnosis, patients with SA were more likely to be infected with HIV-1 (P = 0.005, or 6.3; 95% CI 1.7 22.2). Prevalence rate estimates of SA among HIVpos and HIVneg patients were 0.5 and 0.25%, respectively (P = 0.38). We conclude that HIV-1 infection appears as a risk factor for SA among patients hospitalized at the Centre Hospitalier de Kigali, but that SA cannot be used as a predictor for HIV-1 infection for hospitalized patients. SA occurs infrequently and may present at any stage of HIV-1 infection.
authors.affiliation: Department of Internal Medicine, Centre Hospitalier de Kigali, Rwanda.
authors.forename: A
authors.initials: A
authors.lastname: Saraux
authors.forename: H
authors.initials: H
authors.lastname: Taelman
authors.forename: P
authors.initials: P
authors.lastname: Blanche
authors.forename: J
authors.initials: J
authors.lastname: Batungwanayo
authors.forename: J
authors.initials: J
authors.lastname: Clerinx
authors.forename: A
authors.initials: A
authors.lastname: Kagame
authors.forename: L
authors.initials: L
authors.lastname: Kabagabo
authors.forename: J
authors.initials: J
authors.lastname: Ladner
authors.forename: P
authors.initials: P
authors.lastname: Van de Perre
authors.forename: P
authors.initials: P
authors.lastname: Le Goff
authors.forename: J
authors.initials: J
authors.lastname: Bogaerts
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006679:HIV Seropositivity / Q000188:drug therapy; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013582:Synovial Fluid / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents