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Joint Bone Spine
Volume 84, n° 1
pages 29-33 (janvier 2017)
Doi : 10.1016/j.jbspin.2016.04.004
accepted : 17 February 2016
Osteoarticular manifestations associated with HIV infection
 

Nadia Mehsen-Cêtre a, , Charles Cazanave b, c, d
a Service de rhumatologie, CHU de Bordeaux, place Amelie-Raba-Léon, 33076 Bordeaux, France 
b USC EA3671, Infections humaines à mycoplasmes et à chlamydiae, University Bordeaux, 33076 Bordeaux, France 
c USC EA3671, Infections humaines à mycoplasmes et à chlamydiae, INRA, 33000 Bordeaux, France 
d Service des maladies infectieuses et tropicales, CHU de Bordeaux, 33076 Bordeaux, France 

Corresponding author. Service de Rhumatologie, CHU de Bordeaux, place Amelie-Raba-Léon, 33076 Bordeaux, France.
Abstract

About 150,000 people are HIV-positive in France, and the number of new cases is estimated at 7000–8000 per year, with no tendency to diminish over time. Admissions of HIV-positive patients have been decreasing, in contrast, since 2008, reflecting the dramatic improvements in quality of life and survival provided by triple antiretroviral regimens. HIV infection is now a chronic disease that exposes patients to the virus and antiretroviral drugs for many years. One consequence has been the emergence of new health conditions in HIV-positive patients, such as tumors, cardiovascular disease, and osteoarticular complications. These epidemiological and clinical changes have made it necessary for rheumatologists to learn about the osteoarticular abnormalities associated with the HIV, which they are likely to encounter at some point during their everyday practice. Osteoporosis is one such abnormality, and this review article starts with a discussion of the literature on this topic. Bone loss is common, chiefly in males. Multiple factors are involved. Studies have demonstrated an increase in the fracture risk and, consequently, recommendations about the screening and treatment of osteoporosis have been issued. The focus of this review article then turns to the other rheumatic manifestations seen in HIV-positive patients, including osteomalacia, avascular necrosis, and inflammatory joint disease. Osteoarticular pain is frequently reported by HIV-positive patients. Identifying the cause is essential to determine the best treatment strategy. Interestingly, immunosuppressant drugs, and even biotherapies, have shown a good safety profile in these immunodeficient patients.

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Keywords : HIV, Osteoporosis, Arthralgia, Inflammatory joint disease




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