Department for Dermatology, Venerology, and Allergology, Medical University of Innsbruck, Innsbruck, Austria.
Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
Int J STD AIDS. 2024 Mar;35(3):234-239. doi: 10.1177/09564624231211019. Epub 2023 Nov 14.
: The incidence of pyogenic spondylodiscitis has been increasing in countries of Europe and North America, probably due to an increasing number of persons with risk factors for this infection. It is unclear whether HIV infection in the era of antiretroviral therapy (ART) increases the risk for spondylodiscitis. : We present 7 cases of pyogenic spondylodiscitis of the cervical, thoracic, and lumbar spine in six individuals living with HIV under ART with suppressed viral load. : All patients presented with severe non-radicular pain and elevated inflammatory markers. Diagnosis was confirmed by magnetic resonance imaging (MRI) scan and isolation of the pathogen. was the causative pathogen in five patients. One patient suffered from an infection with followed by a mixed infection with and 18 months later. All patients needed surgical intervention, and the mean duration of antibiotic treatment was 17 weeks (range 12-26). Five patients recovered fully, including two persons who also suffered from endocarditis. One patient died from multi-organ failure. : Spondylodiscitis may be seen more frequently in persons living with HIV as they grow older and suffer from comorbidities which put them at risk for this infection. HIV physicians should be aware of the infection and its risk factors.
化脓性脊椎炎在欧洲和北美的发病率一直在上升，这可能是由于具有这种感染危险因素的人数增加所致。在抗逆转录病毒疗法（ART）时代，HIV 感染是否会增加脊椎炎的风险尚不清楚。
我们报告了 6 名接受 ART 治疗且病毒载量得到抑制的 HIV 感染者的 7 例颈、胸和腰椎化脓性脊椎炎病例。所有患者均表现出严重的非神经根性疼痛和炎症标志物升高。通过磁共振成像（MRI）扫描和病原体分离来确诊。5 例患者为 引起的感染，1 例患者先感染 ，18 个月后又发生 与 的混合感染。所有患者均需要手术干预，抗生素治疗的平均持续时间为 17 周（范围 12-26 周）。5 例患者完全康复，其中包括 2 例同时患有心内膜炎的患者。1 例患者死于多器官衰竭。
随着年龄的增长，HIV 感染者会出现更多的脊椎炎，并且会出现使他们易患这种感染的合并症，因此脊椎炎的发病率可能会更高。HIV 医生应该了解这种感染及其危险因素。
