[Osteonecrosis in HIV-infected patients and its correlation with highly active antiretroviral therapy (HAART)].
BACKGROUND
The incidence of osteonecrosis has increased in HIV-infected patients over the last few years, and has been considered as a side effect of highly active antiretroviral therapy (HAART), possibly related to drug-induced hyperlipidemia. We report seven cases.


METHODS
Seven HIV-infected persons, 6 males and one female, aged 29 to 49 years, and with advanced immunodeficiency (lymphocyte CD4 count<250 cells/mm3 in all the cases). Osteonecrosis generally involved the head of the femoral, clinically presented pain and difficulty walking, and was diagnosed by magnetic resonance imaging or skeletal scintigraphy.


CONCLUSIONS
Among these 7 patients with osteonecrosis, only 4 received antiretroviral therapy at the time of the diagnosis, one presented moderate hypertriglyceridemia, and 3 had positivity for the anti-phospholipid antibodies. Hence, HAART, dyslipidemia, and auto-immunity may enhance, but are not necessarily elements in the onset of HIV-associated avascular bone necrosis.
Calza
Leonardo
L
Département de médecine clinique et expérimentale, section de maladies infectieuses, Alma Mater Studiorum Université de Bologna, Hôpital S.Orsola, Bologna, Italie. malinf@med.unibo.it
Manfredi
Roberto
R
Chiodo
Francesco
F
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D017152:Antibodies, Antiphospholipid / Q000032:analysis; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D011877:Radionuclide Imaging; D013997:Time Factors
D019380:Anti-HIV Agents; D017152:Antibodies, Antiphospholipid
Ostéonécrose chez les patients infectés par le VIH et ses relations avec la thérapie antirétrovirale hautement active (HAART).