Rheumatologic manifestations of infection with the human immunodeficiency virus (HIV)

The aim of this study was to assess the type and frequency of rheumatologic manifestations among patients followed at an HIV clinic in a general hospital, and to evaluate the usefulness of a questionnaire in identifying the presence of these manifestations. Fifty-two consecutive patients with HIV infection completed a questionnaire regarding the presence of rheumatologic symptoms. All patients were interviewed and examined for the prevalence and spectrum of musculoskeletal manifestations. The questionnaire was found to be sensitive in identifying patients with rheumatologic manifestations which were detected on clinical examination. The latter were found in 34 patients (65.3%). Twenty-one patients (40.3%) had arthralgias, 8 (15.2%) had spondyloarthropathies (including Reiter's syndrome, psoriatic arthritis and undifferentiated spondyloarthropathy). Two patients (3.8%) had oligoarthritis and one case each had myositis, Sjögren's syndrome and Behçet's syndrome. Muscle pain was common, occurring in 35% of the patients, and it was related to the use of zidovudine therapy. In contrast to previous reports, most of the patients with arthritis had mild disease, responding promptly to non-steroidal anti-inflammatory drugs. This difference may be explained by the use of zidovudine therapy, stage of HIV infection, and lifestyle. A questionnaire may be helpful in identifying the prevalence of rheumatologic manifestations in HIV-infected subjects.