Arthritis and HIV: Is There a Connection?

Rheumatic Disease Associated With HIV May Alter Usual Treatment and Prognosis

Arthritic patient undergoing physical therapy in a clinic. Credit: John Lund/Drew Kelly / Getty Images

HIV and Arthritis/Other HIV-Associated Rheumatic Diseases

HIV (human immunodeficiency virus), the virus which causes AIDS (acquired immune deficiency syndrome) can also cause:

  • arthritis pain
  • joint pain
  • muscle pain
  • muscle weakness

HIV-associated rheumatic diseases can include:

  • Osteomyelitis - a bone infection usually caused by bacteria
  • Polymyositis - a connective tissue disease characterized by inflammation and degeneration of the muscles
  • Vasculitis - inflammation of the blood vessels
  • Infected joints - originates from an infection elsewhere in your body and is carried to the affected joint
  • Fibromyalgia - a condition characterized by body aches, pain, sleep problems, extreme fatigue, depression, anxiety, tender points

Diagnosing HIV-Associated Rheumatic Diseases

According to the American College of Rheumatology (ACR), "HIV-associated rheumatic diseases may precede the diagnosis of HIV." If a person is at high risk for the HIV virus and presents symptoms of painful joints, painful muscles, or other rheumatic symptoms, testing for the HIV virus could confirm or rule out the diagnosis of HIV. HIV-associated rheumatic diseases can affect any age group, race, or gender, but most commonly affects people between 20-40 years old.

Treating HIV-Associated Rheumatic Diseases

Immunosuppressive medications, such as ​methotrexate and Imuran, are commonly prescribed for the treatment of certain types of arthritis. However, immunosuppressive therapy may be contraindicated for patients with an HIV infection.

HAART (Highly Active Anti-Retroviral Therapy), has been effective in treating rheumatic problems associated with HIV.

Patients with HIV-associated rheumatic diseases also benefit from treatment with pain medications and anti-inflammatory drugs.

Key Points About HIV and Rheumatic Diseases

  • Any rheumatic disease can occur without HIV infection.
  • 30-70% of HIV infected persons may develop an associated rheumatic disease.
  • The presence of an associated rheumatic disease worsens the prognosis of an HIV infection.

Extra Information: What's the Difference Between HIV and AIDS?

Many people automatically equate HIV with AIDS. However, HIV and AIDS are separate clinical entities. Specifically, a person is initially affected with the HIV virus, but it may take a few years to develop AIDS. Furthermore because our treatment of HIV/AIDS has advanced significantly, many people with HIV who vigilantly take daily antiretroviral treatments have a good chance of never decompensating to a point where they develop AIDS and go on to live otherwise healthy lives.

HIV infection attacks CD4 cells (T cells) which help our bodies fight off infection.

When CD4 cell counts fall to below 200 cells/cubic millimeter, a person develops AIDS. Alternatively, a person can develop AIDS if they develop an opportunistic infection.

What's an HIV/AIDS Opportunistic Infection?

HIV/AIDS is most commonly associated with opportunistic infections. An opportunistic infection is caused by bacteria, viruses, fungi or protozoa which take advantage of the host's weakened immune system. Rheumatic disease isn't an opportunistic infection. However, opportunistic infections are instantly what comes to mind when physicians and other healthcare professional think of HIV/AIDS and associated Illnesses.

Here are some opportunistic infections associated with HIV/AIDS:

  • candida
  • cryptococcus
  • cytomegalovirus
  • histoplasmosis
  • MAC
  • PCP
  • toxoplasmosis
  • tuberculosis

More Information:

Sources:

American College of Rheumatology - HIV-Associated Rheumatic Diseases

Merck Manual - Infections of Bones and Joints

American Academy of Family Physicians - Reactive Arthritis

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