Rheumatic manifestations associated with HIV in the highly active antiretroviral therapy era.
OBJECTIVE
To evaluate the rheumatic manifestations associated with HIV infection in the highly active antiretroviral therapy (HAART) era.


RESULTS
The overall prevalence of rheumatic manifestations in HIV population is approximately 9% with various clinical features. Anti-TNF agents do not appear to adversely affect the CD4 cell counts or viral load if the HIV infection is well controlled prior to initiation of therapy.


CONCLUSIONS
In the HAART era, HIV-infected individuals can be affected by various rheumatic syndromes including arthritis, spondyloarthritis, DILS, vasculitides, connective tissue disease, myopathies, and musculoskeletal diseases. With the use of HAART, the prevalence of spondyloarthritis and Diffuse Infiltrative Lymphocytosis Syndrome has decreased, whereas the musculoskeletal complications of HIV and HAART, such as osteopenia, osteonecrosis, and infection continue to be a concern. With immune restoration, various inflammatory and autoimmune diseases, such as SLE, rheumatoid arthritis, and polymyositis may occur de novo or exacerbate. Most antirheumatic therapies used in HIV-negative individuals appear to be safe and effective in the setting of HIV infection as long as prudent guidelines are followed.
Nguyen
Binh Y
BY
Division of Rheumatology and Clinical Immunogenetics, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Reveille
John D
JD
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000494:pharmacology; D001327:Autoimmune Diseases / Q000139:chemically induced / Q000276:immunology / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D054019:Immune Reconstitution Inflammatory Syndrome / Q000139:chemically induced* / Q000276:immunology / Q000503:physiopathology; D007107:Immune System / Q000187:drug effects / Q000503:physiopathology / Q000821:virology; D009140:Musculoskeletal Diseases / Q000139:chemically induced / Q000276:immunology / Q000821:virology; D012216:Rheumatic Diseases / Q000139:chemically induced* / Q000276:immunology / Q000821:virology*
D018501:Antirheumatic Agents