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Rheumatologic manifestations of pediatric HIV infection
H Martínez-Rojano1, E Juárez Hernández, G Ladrón De Guevara
1Department of Pediatrics, Pediatrics and Gynecology Hospital 3-A of the Mexican Institute of Social Security (IMSS), Mexico City, Mexico.
Insights
Rheumatologic manifestations, including vasculitis and Raynaud's syndrome, occurred in 19.2% of pediatric human immunodeficiency virus (HIV) patients. These symptoms were more frequent in advanced HIV disease stages.
Area of Science:
- Pediatric Rheumatology
- Infectious Diseases
- Immunology
Background:
- Pediatric human immunodeficiency virus (HIV) infection can present with diverse clinical manifestations.
- Understanding rheumatologic complications is crucial for comprehensive pediatric HIV care.
- Previous studies have highlighted rheumatologic issues in adult HIV patients.
Purpose of the Study:
- To determine the frequency of rheumatologic manifestations in children with HIV.
- To analyze the association between rheumatologic symptoms and HIV disease stage.
- To compare rheumatologic findings in HIV-infected children with HIV-negative controls.
Main Methods:
- Retrospective study of 26 HIV-infected children and 25 HIV-negative controls.
- Assessment of rheumatologic manifestations using American College of Rheumatology criteria.
- Laboratory tests included CD4+/CD8+ T cells, antinuclear antibodies (ANA), anticardiolipin (ACL) antibodies, and rheumatoid factor (RF).
Main Results:
- Rheumatologic manifestations were identified in 5 (19.2%) of 26 HIV-infected children.
- Observed conditions included biphasic Raynaud's syndrome, necrosing vasculitis, lip necrosis, livedo reticularis, arthralgias, and septic arthritis.
- All identified rheumatologic cases occurred in advanced stages of HIV disease and were associated with positive ANA and ACL antibodies.
Conclusions:
- Rheumatologic manifestations are observed in a significant proportion of pediatric HIV patients, particularly in advanced disease stages.
- These findings mirror those seen in adult HIV populations.
- Rheumatologic symptoms should be recognized as part of the clinical spectrum of pediatric HIV/AIDS.
Abstract:
In order to assess the frequency of rheumatologic manifestations at different stages of pediatric human immunodeficiency virus (HIV) infection, 26 HIV-infected children at any stage of infection, seen at the Children's AIDS Clinic of "La Raza" National Medical Center from January 1997 to December 1998, were studied. Rheumatologic manifestations were assessed following the criteria established by the American College of Rheumatology. Blood samples were taken for measuring CD4+ and CD8+ T cells, antinuclear antibodies (ANA), anticardiolipin (ACL) antibodies, and rheumatoid factor (RF). The results were compared to those of 25 HIV-negative children of similar ages. Rheumatologic manifestations were identified in 5 (19.2%) of 26 children. Two of whom were twin sisters with biphasic Raynaud's syndrome, and one had necrosing vasculitis of a finger, as well as lip necrosis and livedo reticularis. These patients were positive for ANA and ACL. One case each of knee arthalgias, vasculitis, and septic arthritis of the ankle were also seen. All of the rheumatologic manifestations were in advanced stages of HIV disease. These rheumatologic changes are similar to those reported for HIV-positive adults, and should be considered as part of the HIV acquired immune deficiency syndrome (AIDS) clinical spectrum in the pediatric population.