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Osteonecrosis and human immunodeficiency virus infection
J Rademaker1, J S Dobro, G Solomon
1Department of Medicine, Beth Israel Medical Center, New York City, NY 10003, USA.
The Journal of Rheumatology
|March 1, 1997
Summary
Human immunodeficiency virus (HIV) infection may predispose patients to osteonecrosis (bone death). This association is likely due to thrombosis, potentially linked to anticardiolipin antibodies or protein S deficiency.
Area of Science:
- Medicine
- Virology
- Hematology
Background:
- Osteonecrosis, or bone death, can occur due to various factors.
- Human immunodeficiency virus (HIV) infection is a complex systemic disorder.
- The link between HIV infection and osteonecrosis requires further investigation.
Observation:
- Six patients with osteonecrosis and HIV infection were reviewed.
- None of the patients had other known risk factors for osteonecrosis.
- Avascular necrosis (AVN) was noted to occur in multiple sites and early in HIV infection.
Findings:
- HIV infection may be a predisposing factor for osteonecrosis.
- The proposed mechanism involves thrombosis, possibly mediated by anticardiolipin antibodies.
- Acquired deficiency of protein S is another potential contributing factor.
Implications:
- HIV infection should be considered a potential cause of multifocal osteonecrosis.
- Patients with idiopathic, multifocal osteonecrosis warrant evaluation for HIV risk factors.
- Understanding this association may improve patient outcomes and diagnostic approaches.