HIV Related Rheumatologic Conditions

Aka: HIV Related Rheumatologic Conditions, Rheumatologic Manifestations of HIV, HIV Related Rheumatologic Complications, Musculoskeletal Conditions in HIV

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II. Epidemiology

  1. Patients report musculoskeletal symptoms: 75%
  2. Severe Rheumatologic Disease is a rare HIV Complication

III. Associated Conditions: HIV Associated Rheumatic Conditions

  1. Osteoporosis
    1. Reduced Bone Mineral Density and Increased Fracture risk by 15-50%
    2. Contributing factors include lower body weight, chronic inflammation, low CD4 Counts, Tobacco Abuse
    3. Osteomalacia and Vitamin D Deficiency is found in 80% of patients with HIV Infection
    4. Antiretroviral therapy alone is associated with a 2-6% decrease in Bone Mineral Density in first 2 years of use
      1. Highest risk with TDF, Efavirenz, boosted Protease Inhibitors
      2. Brown (2015) Clin Infect Dis 60(8): 1242-51 [PubMed]
  2. Arthralgias (27% of HIV patients)
    1. Arthralgias
    2. Septic Arthritis
    3. Reiter's Syndrome
    4. Spondyloarthropathy
    5. Psoriatic Arthritis
    6. Reactive Arthritis
    7. Sjogren's Syndrome
  3. Myalgias
    1. Myalgias
    2. Drug-Induced Myopathy (including Antiretroviral therapy agents)
      1. Polymyositis
      2. Zidovudine-induced Myopathy
      3. Rhabdomyolysis
  4. Advanced HIV and aids related musculoskelatal syndromes
    1. Vasculitis
    2. Diffuse infiltrative Lymphocytosis syndrome (DILS)
    3. Lupus-Like Syndrome

IV. References

  1. Chu (2017) Am Fam Physician 96(3): 161-9 [PubMed]
  2. Jaqua (2026) Am Fam Physician 113(1): 71-9 [PubMed]

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