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Inflammatory musculoskeletal disorders associated with HIV can affect up to 60% of individuals with the virus that causes AIDS. The HIV virus can cause arthritis, muscle pain and weakness, and neuralogic problems, problems which sometimes appear before the patient is diagnosed with HIV/AIDS.

HIV-associated rheumatic disorders can affect any age group, although they are more common in young individuals between the ages of 20 to 40 years.

HIV-associated rheumatic disorders often improve with the treatment of HIV.

Some of the medicines used to treat HIV/AIDS can cause pain or weakness. If musculoskeletal problems do occur, medications should be reviewed.

These are disorders of the joints and muscles that can result from the HIV virus. Painful joints and muscles are usually the first and most common complaints. Less common, but as important, are the other rheumatic disorders that can occur including infectious complications such as infected joints, infections in the bones (osteomyelitis), psoriatic arthritis, reactive arthritis, polymyositis (inflammation of muscles), fibromyalgia, lymphomas, and inflammation of blood vessels (vasculitis).

Patients with HIV may also experience musculoskeletal complications such as muscle disease (myopathy) resulting from medicines used to control HIV infection.

What causes HIV-associated rheumatic diseases

The musculoskeletal complications of HIV-associated rheumatic disorders have a number of different causes. Infections can play an important role in causing these complications.

Who gets HIV-associated rheumatic diseases

HIV-associated rheumatic disorders affect individuals of all ages, ethnicities and genders. Common risk factors for HIV include sexual promiscuity, unprotected sex, IV drug abuse and, less commonly, blood transfusion.

How HIV-associated diseases are diagnosed

HIV-associated rheumatic diseases are suspected when an individual who is at high risk for HIV infection develops painful joints and muscles or any other rheumatic condition. The diagnosis is confirmed by the appropriate tests for HIV.

How they are treated

The specific highly active antiretroviral therapy HAART (often referred to as the “cocktail” of HIV drugs) introduced in the past 10 years has had a significant impact in the development of HIV-related symptoms including inflammatory musculoskeletal complaints. Thanks to HAART, both the frequency and clinical severity of the rheumatic disorder and long-term prognosis have improved.

Additionally, most HIV patients with musculoskeletal complaints respond well to conventional therapy with a combination of pain relievers and anti-inflammatory medications. Those who do not respond to conventional therapy may require immunosuppressive medication and physical therapy to relieve symptoms, prevent joint deformities and, most importantly, preserve musculoskeletal function.

Prevention

Some of the risk factors associated with HIV are shared with the risks of associated rheumatic diseases. To prevent these risk factors, all individuals should advocate for safe sex, and those afflicted with HIV should practice better compliance with specific antiretroviral therapy.

Living with HIV-associated diseases

HIV-associated musculoskeletal pain causes discomfort, difficulty with muscular strength and coordination, and impairment in everyday functioning. A well-balanced diet and an exercise program are the best combatants for these HIV patients.

HIV-associated rheumatic disease may precede the diagnosis of HIV infection.

Any musculoskeletal syndrome in non-HIV infected patients can occur in HIV-infected patients. However, these syndromes are not necessarily related to the HIV infection.

The introduction of HAART has had a major beneficial effect on HIV infection and its associated rheumatic complaints.

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