Musculoskeletal and rheumatological disorders in HIV infection: Experience in a tertiary referral center

Abstract

Background: Musculoskeletal involvement in human immunodeficiency virus (HIV) infected patients are important disease manifestations, responsible for increased morbidity and also decreased quality of life.

Objectives: To study the spectrum of different musculoskeletal involvement in HIV infected patients and its impact on quality of life.

Patients and methods: Three hundred (n = 300) HIV-1 reactive patients were evaluated in respect to different musculoskeletal involvement including the quality of life from January 2010 to January 2011.

Results: Male to female ratio was 11:1 with a mean age of 35 (±6.4) years and mean duration of the disease was 3 (±1.54) years. Majority of cases were truck drivers, motel workers, and jewelry workers. Musculoskeletal disorders were observed in a total of 190 cases (63.33%). The spectrum of musculoskeletal involvement was: Body ache in 140 (46.7%), arthralgia in 80 (26.7%), mechanical low back pain in 25 (8.3%), osteoporosis in 20 (6.7%), painful articular syndrome in 10 (3.3%), hypertrophic osteoarthropathy in two (0.7%), pyomyositis in two (0.7%), osteomyelitis in one (0.3%), and avascular bone necrosis in one patient (0.3%). Rheumatologic disorders associated were: Reactive arthritis in seven (2.3%), fibromyalgia in four (1.3%), septic arthritis in three (1%), acute gout in three (1%), spondyloarthropathy in two (0.7%), rheumatoid arthritis in two (0.7%), dermatomyositis in one (0.3%), and systemic lupus erythematosus (SLE) in one patient (0.3%). But HIV associated arthritis and diffuse infiltrative lymphocytosis syndrome (DILS) were not detected. Most of the patients had decreased quality of life.

Conclusions: Musculoskeletal involvement was common in HIV patients causing increased morbidity, so early detection and timely intervention is essential to improve quality of life.

Keywords: Human immunodeficiency virus infection; musculoskeletal disorder; quality of life.

Figure 1

Osteoarthritis with effusion involving left knee joint in a HIV patient

Figure 2

Osteomyelitis in a HIV patient involving ankle joint

Figure 3

Reactive arthritis in a human immunodeficiency virus patient involving left ankle, erythema nodosum involving both shin bone

Figure 4

Reactive arthritis in a HIV patient with bilateral knee joint effusion

Figure 5

Septic arthritis in a HIV patient involving left knee joint

Figure 6

Rheumatoid arthritis with deformity in a HIV patient

Figure 7

Rheumatoid arthritis without deformity in a HIV patient

Figure 8

Adhesive capsulitis in a HIV patient involving right shoulder joint