Joint Manifestations in HIV Infection: A Review

There is a diversity of literature on varying aspects of HIV. Central nervous system, cardio-pulmonary and abdominal complications affecting people living with HIV infection and AIDS.(PLWHA) have been extensively discussed in the literature. However, research has recently focused on how the disease affects the musculoskeletal system. It is necessary to focus among various joint manifestations in order to diagnose and properly treat various orthopedic, rheumatologic and pain symptoms amongst PLWHA. Musculoskeletal manifestations can occur at any phase of the infection but they are commonly seen in late phases. Theincidence of rheumatic manifestations in HIV infection was reported in about 4to 71.3% cases in different studies. Although musculoskeletal abnormalities in PLWHA are not as common as other systemic disorders but a wide variety of osseous, articular, muscular and soft tissue diseases may be seen. Many of these conditions are not specific for HIV infection and AIDS and can be seen in other forms of immunosuppression. However, I will be focusing only on joint disease in this review.

Epidemiology:

Studies show that musculoskeletal conditions affect 72% of HIVinfected individuals during their lifespan. In a prospective study of 74 consecutive HIV +ve patients clinical features of rheumatic manifestations were compared with 72 controls HIV –ve subjects with similar risk factors for HIV. HIV +ve group had more rheumatological manifestations than the HIV -ve group: arthralgias were found in 45%, arthritis in 10%, and Reiter’s syndrome in 8%. Thus, the study suggested that rheumatic manifestations more prevalent in HIV +ve patients.

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