Prevalence and characteristics of articular manifestations in Human Immunodeficiency Virus Infection

Abstract

Background: Articular manifestations have been reported in HIV infection with a prevalence ranging from 2.5 to 68%. Objectives: To determine the prevalence, types and characteristics of articular manifestations in the anti-retroviral treatment naive HIV infected patients. Design: Cross sectional descriptive study. Setting: Comprehensive care clinic (HIV outpatient clinic) at the Kenyatta National Hospital (KNH) from October 2007 to March 2008. Subjects: One hun dread and ninety three patients; 135 females and 58 males, aged between 19 to 65 years with Human immunodeficiency virus (HIV) infection who were naive to anti - retroviral drug therapy. Main outcome measure: Presence of articular manifestations that included HIV associated arthritis, HIV associated spondyloarthropathies, HIV associated arthralgia, painful articular syndrome and avascular necrosis. Results: Thirty three of these 193 patients had articular manifestation with a prevalence of 17.1 %. The type prevalence was; HIV associated arthralgia, 15.6%; undifferentiated spondyloarthropathy,l % and HIV associated arthritis; 0.5%. Their mean age was 36 ± 9 years, range 23-63 years; majority were female, male to female ratio of 1: 2.3 and the majority were in World health organization (WHO) clinical staging of HIV infection, class II and III with a mean CD4 cell count of 330 cells/mm". Seventeen (51.5%) of the patients with articular disease had oligo - articular presentation, 10(30.3%) mono -articular while 6(18.2%) had poly - articular presentation. The mean duration of joint pains was 53.3 days (range of 2-365 days). Six (18.2%) of these 33 patients missed work, home making activities or school due to the articular disease. Conclusion: Articular manifestations are common in HIV infection with a prevalence of 17.1 %. HIV associated arthralgia was the most common manifestation. Majority of these patients were female, male to female ratio of 1: 2.3. The mean age of these patients was 36 years with a mean CD4 cell count of 330 cells/rum" with 18.2 % of them missing school or work.