title: Human immunodeficiency virus-associated polymyositis: a longitudinal study of outcome.
abstract: OBJECTIVE
  To determine the clinical course and optimum treatment of human immunodeficiency virus (HIV)-associated myositis.
  
  
  METHODS
  Sixty-four patients attending a county outpatient HIV/acquired immunodeficiency syndrome facility were referred for the presence of elevated creatine kinase (CK) levels or muscle weakness. Patients underwent neurologic and rheumatologic evaluation, electromyography, and muscle biopsy after exclusion for recreational drug or alcohol use, metabolic/endocrine disorders, zidovudine therapy, and other infections.
  
  
  RESULTS
  Thirteen patients (20%) had biopsy-proven myositis. The median duration of HIV infection prior to diagnosis of myositis was 4.3 years (range 0-11 years). Six patients had concomitant diffuse infiltrative lymphocytosis syndrome. There was no correlation of severity of weakness, stage of HIV infection, or retroviral treatment with the CK level at diagnosis. Eight patients received prednisone (60 mg/day) with 5 attaining complete resolution of myositis. The remaining 3 patients received immunosuppressive therapy (azathioprine or methotrexate and intravenous immunoglobulin) and had normalization of strength and CK. Four patients had spontaneous resolution of their myositis without treatment.
  
  
  CONCLUSIONS
  HIV-associated myositis occurs at any stage of HIV infection, has a relatively good prognosis, responds well to immunosuppressive therapy, and has little evidence of adverse outcome on the HIV infection.
authors.affiliation: University of Texas-Houston Health Science Center, Houston 77030, USA.
authors.forename: Randall W
authors.initials: RW
authors.lastname: Johnson
authors.forename: Francis M
authors.initials: FM
authors.lastname: Williams
authors.forename: Salahuddin
authors.initials: S
authors.lastname: Kazi
authors.forename: Mazen M
authors.initials: MM
authors.lastname: Dimachkie
authors.forename: John D
authors.initials: JD
authors.lastname: Reveille
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001706:Biopsy; D016516:CD4-CD8 Ratio; D003402:Creatine Kinase / Q000097:blood; D004576:Electromyography; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D017285:Polymyositis / Q000188:drug therapy* / Q000473:pathology / Q000821:virology*; D011239:Prednisolone / Q000008:administration & dosage; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D000893:Anti-Inflammatory Agents; D011239:Prednisolone; D003402:Creatine Kinase