Viral infections, acquired immunodeficiency syndrome, and rheumatic diseases

There is increasing evidence of a role for viruses in the pathogenesis and etiology of rheumatic diseases. Although definitive evidence of any involvement in diseases such as rheumatic arthritis and systemic lupus erythematosus is currently lacking, there is increasing evidence that viruses may be involved in the pathogenesis of related diseases. In particular, the recent world-wide epidemic of human immunodeficiency virus infection has been associated with the identification of a wide variety of rheumatic manifestations, most notably oligoarthropathies, psoriatic arthropathies, and Reiter's-like syndromes. The spectrum of rheumatic diseases associated with human immunodeficiency virus infection appears to be expanding at a considerable rate. Other viruses have also been shown to be associated with rheumatic disorders, most notably hepatitis viruses, human T lymphotropic virus type I, and parvoviruses. In the latter case, acute arthropathies and those resembling rheumatoid arthritis and Lyme arthritis have recently been identified. This review presents some of the evidence in the recently published literature on the role of different viruses and their implications in the pathogenesis of various rheumatic diseases.