RT Book, Section
A1 Yazdany, Jinoos
A1 Manno, Rebecca L.
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1184193556
T1 Rheumatic Manifestations of HIV Infection
T2 Current Medical Diagnosis & Treatment 2022
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264269389
LK accessmedicine.mhmedical.com/content.aspx?aid=1184193556
RD 2024/04/18
AB Infection  with  HIV  has  been  associated  with  various  rheumatic  symptoms  and  may  coexist  with  autoimmune  rheumatic  diseases,  such  as  rheumatoid  arthritis,  psoriatic  arthritis,  or  spondyloarthritis.  HIV  painful  articular  syndrome  with  acute  infection  causes  severe  arthralgias  in  an  oligoarticular,  asymmetric  pattern  that  resolve  within  24  hours;  the  joint  examination  is  normal.  HIV-associated  arthritis  is  an  asymmetric  oligoarticular  process  with  objective  findings  of  arthritis  and  a  self-limited  course  that  ranges  from  weeks  to  months.  Psoriatic  arthritis  and  reactive  arthritis  occur  in  HIV-infected  individuals  and  can  be  severe.  Along  with  antiretroviral  therapies,  immunosuppressive  medications  can  be  used  if  necessary  in  HIV-infected  patients,  though  with  caution.  Muscle  weakness  associated  with  an  elevated  creatine  kinase  can  be  due  to  nucleoside  reverse  transcriptase  inhibitor–associated  myopathy  or  HIV-associated  myopathy;  the  clinical  presentations  of  each  resemble  idiopathic  polymyositis  but  the  muscle  biopsies  show  minimal  inflammation.  Less  commonly,  an  inflammatory  myositis  indistinguishable  from  idiopathic  polymyositis  occurs.  Other  rheumatic  manifestations  of  HIV  include  diffuse  infiltrative  lymphocytosis  syndrome  (with  parotid  gland  enlargement)  and  various  forms  of  vasculitis.