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Related Concept Videos

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Related Experiment Video

Updated: Mar 12, 2026

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
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Rheumatoid arthritis in patients with HIV: management challenges.

Matthew B Carroll1, Joshua H Fields1, Philip G Clerc1

  • 1Department of Rheumatology, Keesler Medical Center, Keesler Air Force Base, Biloxi, MS, USA.

Open Access Rheumatology : Research and Reviews
|November 16, 2016
PubMed
Summary
This summary is machine-generated.

Managing rheumatoid arthritis (RA) in HIV-infected patients is complex. Early RA treatments like hydroxychloroquine and sulfasalazine offer a balance of safety and efficacy for HIV patients.

Keywords:
cardiovascular diseasehuman immunodeficiency virusimmune reconstitution inflammatory syndromeosteoporosisrheumatoid arthritis

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Area of Science:

  • Rheumatology and Immunology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • HIV infection has evolved into a manageable chronic illness, yet its interaction with autoimmune conditions like rheumatoid arthritis (RA) presents ongoing clinical challenges.
  • Historically, RA remission was observed in HIV-infected individuals before effective antiretroviral therapies; however, RA can now develop independently of treatment.
  • The management of RA in the context of HIV requires careful consideration of immunosuppression and potential treatment interactions.

Approach:

  • This review synthesizes current understanding of RA management in HIV-infected individuals, focusing on therapeutic options and associated risks.
  • It examines the safety and efficacy profiles of various RA medications, including hydroxychloroquine, sulfasalazine, methotrexate, corticosteroids, and biologic response modifiers.
  • The approach highlights the challenges in monitoring RA disease activity and managing comorbidities in this patient population.

Key Points:

  • Hydroxychloroquine and sulfasalazine are recommended as initial RA therapies in HIV patients due to a favorable safety-efficacy balance.
  • Methotrexate may be considered, but data are limited, and corticosteroids like prednisone carry risks such as osteonecrosis.
  • Tumor necrosis factor α inhibitors might be suitable when HIV replication is controlled by highly active antiretroviral therapy (HAART).

Conclusions:

  • Effective RA management in HIV patients necessitates balancing symptom control with immune system preservation.
  • Comorbidities like cardiovascular disease and osteoporosis are common due to chronic inflammation from both HIV and RA.
  • Immune reconstitution inflammatory syndrome (IRIS) appears to have a minimal impact on RA onset or progression in HIV-infected individuals initiating HAART.