Prevalence of rheumatic manifestations in HIV patients: A cross-sectional study from Manipur, India
DOI:
https://doi.org/10.15305/ijrci/v5i1/229Keywords:
HIV, AIDS, Rheumatic manifestations, RA, rheumatoid arthritisAbstract
Background: To estimate the prevalence of rheumatic manifestations in HIV patients and to correlate with factors such as age, sex, duration of HIV infection, highly active antiretroviral therapy (HAART) regimen, duration of HAART, Hb%, ESR, CRP and CD4 cell count.
Methods: The study involved 382 HIV patients attending a tertiary healthcare and referral centre at Imphal, Manipur for two consecutive years. A detailed history of each patient was collected and clinical examination was performed. All the subjects were tested for hepatitis B and C co-infections, and CD4 cell count. Statistical analysis was performed using SPSS software (ver. 16).
Results: Rheumatic manifestations were observed in 145 (38.06%) HIV patients, with HIV- associated arthralgia (22.57%) being the most common manifestation. HIV-associated arthralgia showed significant relation with HAART regimen (0.04), Hb% (0.02), ESR (0.04), and CRP (0.001). In addition, factors such as duration of HIV infection (0.05), Hb% (0.01), ESR (0.04), CRP (0.04) and hepatitis B co-infection (0.04) showed significantly correlation with HIV-associated fibromyalgia.
Conclusion: Increased prevalence of rheumatic manifestations was noted in HIV patients, with more incidence in HAART-sensitized population. The study highlights the need to review such manifestations at every follow-up and manage appropriately.
References
The Gap report. Regional snapshots: Asia and the Pacific. Switzerland: UNAIDS; 2014. Available from: http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf
National AIDS control organization. Chapter 24. Annual Report 2015-16. Available from: www.naco.gov.in/NACO/Quink_Links.
Ornstein MH, Kerr LD, Spiera H. A reexamination of the relationship between active rheumatoid arthritis and the acquired immunodeficiency syndrome. Arthritis Rheum. 1995; 38(11): 1701–1706.
Wegrzyn J, Livrozet J-M, Touraine J-L, Miossec P. Rheumatoid arthritis after 9 years of human immunodeficiency virus infection: possible contribution of tritherapy. J Rheumatol. 2002; 29(10): 2232–2234.
Hess EV, Brown AD. New Perspectives from China on HIV Rheumatic Manifestations. J Rheumatol. 2007; 34: 8.
Mahajan A, Tandon VR, Verma S. Rheumatological Manifestations in HIV Infection. Journal, Indian Academy of Clinical Medicine. 2006; 7(2): 136-144.
Berman A, Espinoza LR, Diaz JD, Aguilar JL, Rolando T, Vasey FB, et al. Rheumatic manifestations of human immunodeficiency virus infection. Am J Med. 1988; 85(1): 59–64.
Fox C, Walker-Bone K. Evolving spectrum of HIV-associated rheumatic syndromes. Best Pract Res Clin Rheumatol. 2015; 29(2): 244–258.
Kaddu-Mukasa M, Ssekasanvu E, Ddumba E, Thomas D, Katabira ET. Rheumatic manifestations among HIV positive adults attending the Infectious Disease Clinic at Mulago Hospital. Afr Health Sci. 2011; 11(1): 24–29.
Medina-Rodriguez F, Guzman C, Jara LJ, Hermida C, Alboukrek D, Cervera H, et al. Rheumatic manifestations in human immunodeficiency virus positive and negative individuals: a study of 2 populations with similar risk factors. J Rheumatol. 1993; 20(11): 1880–1884.
Telles JP, Azevedo Grande M, Jurgensen A, Hecke JC, Skare T, Nisihara RM, et al. Rheumatic manifestations in brazilian patients with AIDS. Acta Reumatol Port. 2014; 39(2): 143–145.
Dotan I, Riesenberg K, Toledano R, Schlaeffer F, Smolyakov A, Saidel-Odes L, et al. Prevalence and characteristics of fibromyalgia among HIV-positive patients in southern Israel. Clin Exp Rheumatol. 2016; 34(2 Suppl 96): S34-39.
Johnson RW, Williams FM, Kazi S, Dimachkie MM, Reveille JD. Human immunodeficiency virus-associated polymyositis: a longitudinal study of outcome. Arthritis Rheum. 2003; 49(2): 172–178.
Narayanan K, Batra RB, Anand KP. Rheumatic manifestations of HIV infection. Ind J Rheumatol. 2008; 3(1): 4-7.
Njobvu P, McGill P. Human immunodeficiency virus related reactive arthritis in Zambia. J Rheumatol. 2005; 32(7): 1299–1304.
Basu D, Williams FM, Ahn CW, Reveille JD. Changing spectrum of the diffuse infiltrative lymphocytosis syndrome. Arthritis Rheum. 2006; 55(3): 466–472.
Chinniah K, Mody GM, Bhimma R, Adhikari M. Arthritis in association with human immunodeficiency virus infection in Black African children: causal or coincidental? Rheumatology (Oxford). 2005; 44(7): 915–920.
Miller KD, Masur H, Jones EC, Joe GO, Rick ME, Kelly GG, et al. High prevalence of osteonecrosis of the femoral head in HIV-infected adults. Ann Intern Med. 2002; 137(1): 17–25.
Additional Files
Published
Issue
Section
License
Copyright for articles published in this journal is retained by the authors, with first publication rights granted to the ‘Internet Journal of Rheumatology and Clinical Immunology’. All the published content, except where otherwise noted, is licensed under Creative Commons license (CC-BY).
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) after the publication of the manuscript in IJRCI, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
