Rheumatological disease

Adam Jenny Department of Infectious Diseases and Clinical Microbiology, The Alfred Hospital, Melbourne Last reviewed: August 2019 Introduction In the general population, rheumatological conditions can arise in any age group and are often chronic and progressive. As HIV-infected patients taking antiretroviral therapy (ART) can now achieve almost normal life-expectancy, it is to be expected that …

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In primary HIV infection syndrome, myalgia is quite commonly experienced, occurring in 30% of a Korean cohort (2),  though previously it has been noted to be present in up to a half of patients and that the symptoms could persist for weeks or even months (3). Arthralgia is less common, occurring in approximately a quarter …

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HIV-related arthritis  Weeks or even years after primary HIV infection syndrome is complete, a condition referred to as HIV-related arthritis may occur (5). Most commonly this affects large joints of the upper limbs and knees, in an asymmetric pattern. This can usually be managed by rest, NSAIDs and paracetamol, though occasionally the pain is severe …

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HIV-infection can increase the risk of acquiring avascular necrosis (AVN) of bone (otherwise known as aseptic necrosis) by more than 100-fold over the non-infected population (27). In addition to HIV infection itself, other risks include taking ART, smoking, hyperlipidaemia, corticosteroid use, vasculitis and anti-phospholipid syndrome (28). AVN mainly affects the femoral head but can occur …

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There is a wide variety of vasculitis diagnoses recorded in HIV-infected patients affecting vessels of all sizes. It has been suggested that an excess of CD8+ T-cells may trigger the vessel inflammation, possibly related to opportunistic infections in the context of severe CD4+ T cell depletion. Infections by Toxoplasma gondii, Pneumocystis jiroveci, cytomegalovirus and varicella …

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There is a wide variety of vasculitis diagnoses recorded in HIV-infected patients affecting vessels of all sizes. It has been suggested that an excess of CD8+ T-cells may trigger the vessel inflammation, possibly related to opportunistic infections in the context of severe CD4+ T cell depletion. Infections by Toxoplasma gondii, Pneumocystis jiroveci, cytomegalovirus and varicella …

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Systemic lupus erythematosus (SLE) is a chronic autoimmune condition, characterised by the production of multiple autoantibodies, with a wide variety of inflammatory manifestations including disease of the skin, lungs, kidneys, heart, nervous system, joints and other connective tissue (such as pleura and pericardium). In addition, it can interfere with the production of all blood cell …

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Septic arthritis  Acute bacterial infection of joints is quite rare in HIV-infected patients and when it does occur, it is more likely in people who inject drugs. As is the case in the general population, Staphylococcus and Streptococcus  are the commonest organisms found (3). Early diagnosis with diagnostic aspiration revealing purulent synovial fluid should be …

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Polymyositis and other myopathies  Mild self-limiting myalgia may occur quite commonly during a primary HIV infection syndrome but severe rhabdomyolysis at that time has also been reported (42). Later, and at any time in the course of untreated HIV infection, several different myopathies may manifest with symptoms such as wasting, pain and weakness, which may …

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Espinoza LR, Garcia-Valladares I. Of bugs and joints: the relationship between infection and joints. Reumatol Clin. 2013;9(4):229-38. Lin TY, Yang CJ, Liu CE, Tang HJ, Chen TC, Chen GJ, et al. Clinical features of acute human immunodeficiency virus infection in Taiwan: A multicenter study. J Microbiol Immunol Infect. 2018. Lawson E, Walker-Bone K. The changing …

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