Autoimmune diseases-related arthritis in HIV-infected patients in the era of highly active antiretroviral therapy
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
48
Journal Issue
2
Pages
130-136
Date Issued
2015
Author(s)
Abstract
Autoimmune diseases-related arthritis has been rarely reported in HIV-1-infected patients. We aimed to investigate the incidence and clinical manifestations of autoimmune diseases-related arthritis in HIV-infected patients in the era of highly active antiretroviral therapy (HAART) in Taiwan. Methods: We retrospectively reviewed medical records of all HIV-infected patients who had a diagnosis of autoimmune arthritis between 1993 and 2013. Demographic characteristics, clinical manifestations, serial CD4 and CD8 lymphocyte counts and plasma HIV viral loads, HLA-B27 status, and treatment response to HIV and rheumatic diseases were recorded. Results: During the 20-year study period, totally 26 HIV-infected patients with autoimmune arthritis (0.7%) were diagnosed among 3623 HIV-infected patients. There were 18 patients with ankylosing spondylitis (AS), six with rheumatoid arthritis (RA), one with psoriatic arthritis, and one with Sj?gren's syndrome. HLA-B27 antigens were all detected positive of AS patients. Fifteen patients (57.7%) developed autoimmune arthritis after HAART was initiated. The median age and CD4+ T lymphocyte counts at the diagnosis of autoimmune arthritis were 35 (20-62 years) and 406 (3-695 cells/μL), respectively. Three patients had typical presentations of Reiter's syndrome. Both AS and RA patients achieved a good virological response with undetectable plasma HIV RNA load 12 months after receiving HAART(85.71% vs. 80%, respectively, p=0.999). The treatment response to antirheumatic medications were similar between AS patients and RA patients (77.8% vs. 50%, p=0.3068), but seems to be better than that reported for the general population (30-40%). Conclusion: A low prevalence of autoimmune arthritis among HIV-infected patients in the era of HAART was similar to that of the general Taiwanese population. Clinical manifestations of HIV-infected patients were similar to those described in HIV-uninfected patients. However, the treatment response to antirheumatic agents was better in HIV-infected patients in our study. ? 2013.
SDGs
Other Subjects
adalimumab; C reactive protein; CD4 antigen; CD8 antigen; HLA B27 antigen; hydroxychloroquine; methotrexate; nonsteroid antiinflammatory agent; protein antibody; rheumatoid factor; salazosulfapyridine; steroid; antirheumatic agent; HLA B27 antigen; adult; ankylosing spondylitis; arthritis; Article; autoimmune disease; CD4 lymphocyte count; CD4+ T lymphocyte; clinical article; clinical feature; comparative study; controlled study; disease association; female; highly active antiretroviral therapy; human; Human immunodeficiency virus; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; incidence; lymphocyte count; male; medical record; population; psoriatic arthritis; Reiter syndrome; retrospective study; rheumatic disease; rheumatoid arthritis; Sjoegren syndrome; treatment response; virology; virus load; arthritis; Autoimmune Diseases; CD8+ T lymphocyte; complication; genetics; HIV Infections; immunology; middle aged; pathology; Taiwan; treatment outcome; young adult; Adult; Antiretroviral Therapy, Highly Active; Antirheumatic Agents; Arthritis; Autoimmune Diseases; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Female; HIV Infections; HLA-B27 Antigen; Humans; Incidence; Lymphocyte Count; Male; Middle Aged; Retrospective Studies; Taiwan; Treatment Outcome; Viral Load; Young Adult
Publisher
Elsevier Ltd
Type
journal article