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 diseases affecting joints, muscles and connective tissue will have a greater impact in this group than previously. That said, some rheumatological conditions have always had particular impact in patients with HIV infection and may appear during a primary HIV infection syndrome or any time thereafter. Prompt diagnosis and management can usually reduce the symptoms and prevent, or at least slow, the progression of the condition. Many rheumatological diseases are best treated with immunosuppressive agents, more recently including ‘biologic agents’, and in general, all types of therapy should be considered, especially if the HIV infection is controlled by ART.

  The major rheumatological conditions that may be experienced by HIV patients are listed in table 1.

Table 1. List of rheumatological conditions found in HIV-infected patients¹.

Myalgia and Arthralgia

Arthritis

            HIV-related arthritis

            Osteoarthritis

            Painful Arc Syndrome

            Reactive arthritis

            Psoriatic arthritis

Gout

            Rheumatoid arthritis

            ART-associated arthritis

Avascular necrosis

Diffuse Infiltrative Lymphocytosis Syndrome

Vasculitis

Systemic Lupus Erythematosus

Bacterial Infections

            Septic arthritis

            Pyomyositis

            Osteomyelitis

Polymyositis and other myopathies

1. Adapted from Espinoza (1)