Clinical Spectrum of Rheumatologic Manifestations in HIV Patients: A Study from Southern India OC01-OC03
Praveen Kumar Yadav,
Flat No. 2C, Salrapuria Gardenia, Martin Luther Road, Bidhan Nagar, Durgapur, West Bengal, India.
Introduction: HIV infection is a common disease in India and a variety of rheumatological manifestations are known to occur in HIV Infection. Rheumatological manifestations are significant cause of morbidity in these patients.
Aim: To study the clinical spectrum and prevalence of rheumatologic manifestations in HIV patients.
Materials and Methods: Patients with HIV 1 and 2 attending the Infectious disease outpatient department of Medical College Hospital, Thiruvananthapuram during the study period (March 2009 to March 2010) were assessed by clinical examination and with relevant laboratory investigations, to diagnose the rheumatological manifestation. Based on the clinical manifestations and investigations a rheumatological diagnosis was made. Patients with diabetes mellitus, hypothyroidism and other pre-diagnosed rheumatologic illness were excluded from the study. Statistical analyses were done using SPSS IBM Statistics 17.0 version and chi-square test.
Results: Out of 385 patients, 161 (41.8%) of HIV patients were in the 30-39 years age group. Male and female were 225 (58.4%) and 160 (41.6%) respectively. A total of 276 (71.7%) patients were receiving antiretroviral therapy (ART). Disease duration of 1-5 year in 174 (45.19%), <1 year in 135 (35.06%) and rest had more than 5 years of disease. A total of 97 (25.2%) of HIV patients had rheumatological manifestations. HIV Arthralgia was the most common manifestation affecting 34 patients (35.1%) of the population with rheumatological manifestations. Knee joint was the most common joint which was involved. The other manifestations noted along with percentage were Myalgia/muscle ache in 18 patients (18.6%), inflammatory back pain in 14 patients (14.4%), soft Tissue Rheumatism in 12 patients (12.4%), undifferentiated spondyloarthropathy in 11 patients (11.3%), fibromyalgia in 9 patients (9.3%), HIV wasting in 7 patients (7.2%), HIV arthritis in 4 patients (4.1%) and psoas abscess (3.1%). Each of plantar fascitis, psoriatic Nail changes, pyomyositis, painful articular syndrome, erythema nodosum and episcleritis constituted about 2.1% each of the rheumatological manifestations. Degenerative joint disease constituted 17.5% of the rheumatological manifestations. One patient had evidence of tuberculosis of the spine.
Conclusion: The rheumatological manifestations are common in HIV Infected patients. HIV arthralgia, myalgia and undifferentiated spondyloarthropathy are the common manifestations.