title: HIV and Orthopaedics: Musculoskeletal Manifestations and Outcomes.
abstract: ➤Advances in combined antiretroviral therapy (cART) in recent years have transformed HIV infection into a chronic disease when treatment is available, increasing a patient's life expectancy and the chances that orthopaedic surgeons will encounter such patients in their clinical practice.➤Musculoskeletal manifestations in patients with HIV infection are common and sometimes are the initial presentation of the disease. Knowledge about neoplasms and associated conditions affecting muscle, bones, and joints is essential for successful management.➤Since the advent of cART, total joint arthroplasty has been shown to be a safe procedure; however, perioperative infection is still a small risk in patients with uncontrolled viral loads or CD4 counts of <400 cells/mm(3).➤With regard to trauma surgery, the rates of early and late infection around implants, as well as union rates, are comparable with those in the HIV-negative population; however, there is an increased risk of pulmonary, renal, and infectious or septic complications in the polytrauma setting.➤Factors such as CD4 count, nutritional status, cART therapy, viral load count, and other comorbidities (hemophilia, infection among intravenous drug users, etc.) should be considered when treating these patients in order to optimize their clinical outcomes.
authors.affiliation: Departments of Orthopaedic Surgery (J.P.-M. and V.H.H.) and Radiology (T.S.), and Division of Infectious Diseases, Department of Internal Medicine (R.C.), University of Miami Miller School of Medicine, Miami, Florida juanpretell@gmail.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Pretell-Mazzini
authors.affiliation: Departments of Orthopaedic Surgery (J.P.-M. and V.H.H.) and Radiology (T.S.), and Division of Infectious Diseases, Department of Internal Medicine (R.C.), University of Miami Miller School of Medicine, Miami, Florida tsubhawong@med.miami.edu.
authors.forename: Ty
authors.initials: T
authors.lastname: Subhawong
authors.affiliation: Departments of Orthopaedic Surgery (J.P.-M. and V.H.H.) and Radiology (T.S.), and Division of Infectious Diseases, Department of Internal Medicine (R.C.), University of Miami Miller School of Medicine, Miami, Florida Vhh1@med.miami.edu.
authors.forename: Victor H
authors.initials: VH
authors.lastname: Hernandez
authors.affiliation: Departments of Orthopaedic Surgery (J.P.-M. and V.H.H.) and Radiology (T.S.), and Division of Infectious Diseases, Department of Internal Medicine (R.C.), University of Miami Miller School of Medicine, Miami, Florida Rcampo@med.miami.edu.
authors.forename: Rafael
authors.initials: R
authors.lastname: Campo
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D009140:Musculoskeletal Diseases / Q000150:complications* / Q000601:surgery; D019637:Orthopedic Procedures; D009985:Orthopedics; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents