Prevalence and characteristics of articular manifestations in human immune virus infection
AbstractBackground: 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 hundread 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, 1 % 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/mm3. 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/mm3 with 18.2 % of them missing school or work.