An approach to the human immunodeficiency virus-positive patient with a spondyloarthropathic disease

One of the unanticipated consequences of infection with the human immunodeficiency virus (HIV) is the appearance of various rheumatic syndromes that traditionally have been thought to result from inappropriate overactivity of the immune system. This distinctive spectrum of rheumatic syndromes has been well described; however, the therapeutics and specific patient management as well as the significance of these disorders for diagnostic classification of the rheumatic disorders have not received a great degree of attention. This article focuses on these areas with emphasis on (1) the nosology of the arthrocutaneous musculoskeletal syndromes with HIV, (2) clinical presentation of the various syndromes, (3) current concepts regarding the etiopathogenesis of the spondyloarthropathic form of arthritis in this setting, and (4) an approach to therapy.