The lesions of the bone and articular system are found in more than 60% of the HIV-infected.
Very often, with HIV infection in patients, there is a lesion of the joints and the spine that can simulate rheumatic diseases and syndromes, therefore they are also called rheumatic masks of HIV infection or rheumatic syndromes in HIV infection.
HIV-infected persons include those in whom the human immunodeficiency virus belonging to the family of retroviruses is detected in the body. This category of patients includes:
- HIV carriers;
- Patients with clinical manifestations of infection;
- AIDS patients - patients with different manifestations that are observed in severe HIV infection by the immune system.
Features of articular syndromes in HIV
Pain in patients with HIV, as a rule, arises in large joints (elbow and shoulder, knee). Their duration usually does not exceed the period of time, sometimes the pain is held for 2-3 hours and spontaneously pass.
At the heart of the pain syndrome is the transient violation of blood circulation in the bone tissue. This is particularly common in the evening and at night, leading to sleep disturbances.
Variants of the course of HIV-associated arthritis
- The oligoarthritis occurs with a predominant affection of the large joints of the lower limbs (ankle and knee). This type of lesions often is asymmetric in nature, accompanied by severe pain syndrome, which may be associated with the development of necrotic processes in the bone tissue. The duration of this type of arthritis most often does not exceed 2 months, the disease can take a week. In the period of exacerbation of pain and limitation of movements in the affected joints, the patient is forced to lead a sedentary lifestyle.
- Symmetrical acutely developed rheumatoid-like arthritis is most common in men and occurs as a polyarthritis with lesions of various groups of joints.
The leading signs indicating the relationship between HIV infection and articular manifestations are:
- Undifferentiated spondylarthropathy - defeat of small intervertebral joints;
- Combined spondylarthritis - the presence of several rheumatoid diseases in one patient (another medical name can be found in the medical literature called "HLA-B27-associated arthritis in HIV-infection").
Forms of combined lesions of the bone and joint system in HIV-infected
Clinical manifestations and various combinations of forms of rheumatic masks in HIV-infected patients are extremely diverse, but the most common are:
- Combinations of psoriatic arthritis with reactive arthritis or with Reiter's syndrome;
- HIV-associated bacterial arthritis associated with secondary opportunistic infection - fungal, tuberculous, herpetic, hepatitis C virus, and other infections;
- Other HIV-associated rheumatic syndromes - polymyositis, vasculitis and vasculopathy, Sjogren's syndrome, etc.;
- HIV-association of soft tissue lesions of around-articular tissues - bursitis, synovitis, tendinitis, adhesive capsule, periarthrosis, carpal tunnel syndrome and other tunnel syndromes, dupiutren contracture, etc.
Prognosis of osteoarthropathy against HIV infection
As a rule, lesions of the bone and articular system are determined by the stage of the most HIV-infection, the form of the defeat of the joints and the spine.
In this case, the complete disappearance of clinical manifestations of arthropathy without residual structural changes and with complete restoration of the function of the joints is possible.
In some cases, especially in the development of AIDS, it is possible to develop severe arthritis that occurs with the phenomena of destruction, which is most often observed with purulent inflammation and/or the admission of fungal infection.