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Rheumatic manifestations in HIV

Publication at First Faculty of Medicine |
2019

Abstract

Diagnosis of Human Immunodeficiency Virus (HIV) infection is still rare in rheumatology outpatient clinics. HIV infection has typically long latent period with a slow progression to the acquired immunodeficiency syndrome (AIDS).

Specific rheumatic symptoms associated with HIV infection are painful joint syndrome, HIV-associated arthritis, HIV-associated arthritis and the diffuse infiltrative lymphocytosis syndrome (DILS). Systemic connective tissue disease may develop de novo in HIV patients, and its manifestations may overlap with the manifestations of infection.

The overlapping manifestations could delay diagnosis of HIV infection in patients with pre-existing rheumatic disease prior to HIV infection. Retroviral therapy effectively slows down the course of HIV infection.

It reduces the prevalence of opportunistic infections and DILS, but it can induce a number of immunological abnormalities. Interestingly, diseases associated with CD4 + lymphocyte activity, such as rheumatoid arthritis or systemic lupus erythematosus are going to remission in the course of HIV infection, but may relapse after effective retrovirus therapy, when level CD4+ rises.

This paper will address the characteristics of rheumatic manifestations in HIV infection.