title: The changing spectrum of rheumatic disease in HIV infection.
abstract: BACKGROUND
  Rheumatic manifestations were described soon after human immunodeficiency virus (HIV) was discovered. Since however, combination anti-retroviral therapy (cART) has revolutionized the course of the infection. Less clear is what effect cART has had on rheumatic manifestations.
  
  
  METHODS
  References were retrieved from the PubMed database using keywords including: 'HIV' and 'arthritis'; 'myalgia'; 'arthralgia' and other disease-specific terms, e.g. 'rheumatoid arthritis'.
  
  
  RESULTS
  Musculoskeletal pain was common in HIV and increased with AIDS. Immune restoration inflammatory syndrome on initiation of cART causes de novo autoimmune inflammatory rheumatic disorders. Seronegative inflammatory arthritis with/without axial involvement has been reported widely with HIV.
  
  
  RESULTS
  It is unclear if HIV causes these conditions, creates an environmental milieu supportive of these conditions or acts as a marker of other risk factors. It is unclear what effect cART has had on these conditions.
  
  
  CONCLUSIONS
  Variable diagnostic classification criteria have caused this literature to be poorly comparable.
  
  
  CONCLUSIONS
  High-quality controlled epidemiological studies using standardized criteria are needed among cART users. Treatment of active autoimmune disease in HIV patients needs to be evaluated formally.
authors.affiliation: St. John's Way Medical Centre, London, UK.
authors.forename: Edwina
authors.initials: E
authors.lastname: Lawson
authors.forename: Karen
authors.initials: K
authors.lastname: Walker-Bone
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D002349:Carpal Tunnel Syndrome / Q000150:complications / Q000628:therapy; D003240:Connective Tissue Diseases / Q000150:complications / Q000628:therapy; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications / Q000628:therapy; D007592:Joint Diseases / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications / Q000628:therapy; D012216:Rheumatic Diseases / Q000150:complications* / Q000628:therapy
chemical_list: D044966:Anti-Retroviral Agents