Maricopa Integrated Health System and University of Arizona College of Medicine, 2525 E Roosevelt Street, Phoenix, AZ, 85008, USA.
University of Washington, 4245 Roosevelt Way NE, Seattle, WA, 98105, USA.
Clin Rheumatol. 2019 Jan;38(1):71-76. doi: 10.1007/s10067-018-4089-z. Epub 2018 Apr 4.
The aim of the study was to calculate the proportion of rheumatic diseases in HIV patients who were receiving ART and to identify association of the HIV medications with the development of rheumatologic diseases. We conducted a retrospective chart review during the period of 2010 to 2016. We identified 2996 patients as having chronic HIV infection and on ART, and we collected data regarding patient's demographic characteristics, comorbidities, CD 4 count, HIV viral load, and ART. One hundred thirteen out of 2996 HIV patients (3.8%) were found to have a rheumatic condition (mean age of 48.6 years, 83% male). The most frequent musculoskeletal condition was avascular necrosis (AVN) in 39 (1.3%), and the most frequent autoimmune condition was psoriasis in 28 patients (1%). Compared with the 200 HIV patients without any diagnosis of rheumatic disease were the older patients with rheumatic conditions (mean age of 48.9 vs. 42.7 years; p < 0.01), and had a longer duration of HIV infection (mean duration of 15.5 vs. 10.3 years; p < 0.01). The odds of rheumatic conditions were 1.7 times higher in males (relative to females). Those who received integrase inhibitors were more likely (63.3%) to develop rheumatologic manifestations relative to those who never received integrase inhibitors (21.6%; p < 0.01). The proportion of rheumatic diseases in HIV patients appears to be comparable to the prevalence in the US population. Older age, longer duration of HIV infection, and the use of ART regimens containing integrase inhibitors, appear to increase the risk of developing a rheumatic condition.
研究目的是计算接受抗逆转录病毒治疗（ART）的 HIV 患者中风湿性疾病的比例，并确定 HIV 药物与风湿性疾病发展的关联。我们对 2010 年至 2016 年期间进行了回顾性图表审查。我们确定了 2996 例患有慢性 HIV 感染和接受 ART 的患者，并收集了患者的人口统计学特征、合并症、CD4 计数、HIV 病毒载量和 ART 数据。在 2996 例 HIV 患者中，有 113 例（3.8%）发现患有风湿性疾病（平均年龄为 48.6 岁，83%为男性）。最常见的肌肉骨骼疾病是 39 例（1.3%）的股骨头坏死（AVN），最常见的自身免疫性疾病是 28 例（1%）的银屑病。与 200 例没有任何风湿性疾病诊断的 HIV 患者相比，患有风湿性疾病的患者年龄更大（平均年龄为 48.9 岁 vs. 42.7 岁；p<0.01），且 HIV 感染时间更长（平均时间为 15.5 年 vs. 10.3 年；p<0.01）。与女性相比，男性发生风湿性疾病的可能性高 1.7 倍。与从未接受过整合酶抑制剂的患者相比，接受整合酶抑制剂的患者发生风湿表现的可能性高 63.3%（相对危险度 [RR]，1.7；95%置信区间 [CI]，1.2-2.5；p<0.01）。HIV 患者中风湿性疾病的比例似乎与美国人群的患病率相当。年龄较大、HIV 感染时间较长以及使用包含整合酶抑制剂的 ART 方案似乎会增加发生风湿性疾病的风险。
