The defeat of the bone and articular system occurs in more than 60% of the infected and is characterized by a pronounced variety of clinical manifestations.
The most common is for combined forms of arthritis and spondylarthritis with HIV:
- Acute onset of rheumatoid arthropathy;
- More severe course of the disease and the presence of multiple lesions with different process localization (arthropathy with myocarditis, arthropathy with polyserositis, or bone and articular lesion in combination with polyneuropathy, etc.);
- High laboratory parameters of the activity of the inflammatory process.
Features of the flow of psoriatic arthritis against the background of HIV
- Psoriasis is found in 1/3 of all HIV-infected people, most often at the stage of AIDS, and this is considered a prognostic disadvantage.
- Psoriatic arthritis occurs with pronounced inflammation of the ligament and tendons (enthesopathy) and phalanges of the fingers (dactylitis), lymphadenopathy (inflammation of regional groups of lymph nodes).
- It is also possible the formation of malignant form of arthritis in which, in addition erythroderma, pustular psoriasis is marked and marked with significant arthritis pain, debilitating fever, weight loss, muscle atrophy, hair loss, severe general condition of the patient.
- In the marked stages of the disease, signs of cardiac and renal insufficiency may occur, as well as malignant flow of psoriatic arthritis, encephalopathy and polyneuropathy, eye damage (iritis, iridocyclites) may develop.
- In the blood analysis gradually increases anemia, there is a significant acceleration of ESR (30-60 mm/year), increases the number of antibodies, gamaglobulins.
- On the background of psoriatic arthritis in HIV-infected people, the risk of opportunistic infections is significantly increased.
Features of leakage of reactive arthritis against HIV
- Typically, these types of arthritis in the context of HIV infection are due to the transmitted Chlamydia, Salmonella, Shigella and Herpes simplex infection.
- The maximum severity of Reiter syndrome is observed in the period of developed immunodeficiency (at the stage of AIDS) and is often accompanied by erosive and destructive changes in the joints.
- Particularly characteristic combinations of arthritis and urethritis, as well as the appearance of dactylites and atypical enthesopathies (such as inflammation of the Achilles tendon and plantar aponeurosis), changes in the skin and nails.
- At the same time, with this pathology, lesions of the mucous membranes and the spine are rare and specific signs of HIV-associated synovitis are not detected.
Features of the course of undifferentiated spondyloarthropathy with HIV
Typical is the extremely diverse localization of changes: several joints (oligoarthritis), spine (spondylitis), dactylitis, atypical enthesopathy, involvement in the process of mucosal oral cavity, genital tract, eye lesions (uveitis), nail fractures (onycholyses) may be affected.
According to scientists, a major role in this is played by the direct damage to HIV tissue of the joints, as well as the violation of immune processes due to transferred infections.