title: Rheumatoid arthritis after 9 years of human immunodeficiency virus infection: possible contribution of tritherapy.
abstract: Infection by human immunodeficiency virus (HIV) may affect joints in different ways. It usually increases the severity of reactive arthritis. Conversely, when rheumatoid arthritis (RA) is seen in association with HIV infection, remission of RA has been observed in some cases. We describe a patient who developed 3 successive forms of joint manifestations: early HIV related arthralgias followed by drug related arthritis, and more recently by typical RA. The first signs of joint manifestations started one year after HIV seroconversion and resolved when antiviral treatment with AZT was started. The second episode ended when lamivudine dosage was reduced. Finally, after 9 years of infection, the diagnosis of seropositive RA was made in this HLA-DR1 positive patient. The symptoms started when the immune status reached normal CD4 T cell levels, in response to antiviral tritherapy. This observation indicates the complex effect of HIV on joint inflammation.
authors.affiliation: Department of Immunology and Rheumatology, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Wegrzyn
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Livrozet
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Touraine
authors.forename: Pierre
authors.initials: P
authors.lastname: Miossec
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D016918:Arthritis, Reactive / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D006678:HIV / Q000302:isolation & purification / Q000472:pathogenicity; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D019259:Lamivudine / Q000008:administration & dosage; D008297:Male; D019258:Saquinavir / Q000008:administration & dosage; D018119:Stavudine / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D019259:Lamivudine; D018119:Stavudine; D019258:Saquinavir