Combined arthropathy in patients with HIV infection

defeat osteoarticular system meets more than 60% of infected people and is characterized by a pronounced diversity of clinical manifestations.

most characteristic of the combined forms of arthritis and HIV spondilartritov:

  • acute onset revmatoidnopodobnoy arthropathy;
  • more severe course of the disease and the presence of multiple lesions with different localization process (myocarditis with arthropathy, arthropathy with poliserozita or destruction of bone and articular apparatus in conjunction with polyneuropathy, etc.);
  • high laboratory parameters of inflammation activity.

Features occurrence of psoriatic arthritis in HIV

  • Psoriasis occurs in 1/3 of all HIV-infected people, most often on the stage of AIDS, and it is considered a poor prognostic sign.
  • Psoriatic arthritis occurs with severe inflammation of the ligaments and tendons (enthesopathies) and phalanges (dactylitis), lymphadenopathy (inflammation of the regional groups of lymph nodes).
  • also possible the formation of malignant forms
    of arthritis, in which, in addition to erythroderma, pustular psoriasis is marked and pronounced polyarthritis with significant pain, debilitating fever, weight loss, muscle atrophy, hair loss, severe general condition of the patient.In
  • expressed stages of the disease may cause symptoms of heart and kidney failure, as in malignant course of psoriatic arthritis may develop encephalopathy and neuropathy, eye disease (iritis, iridocyclitis).
  • In the analysis of blood gradually increasing anemia, there is a significant acceleration of erythrocyte sedimentation rate (30-60mm / hour), increases the number of antibodies, gammaglobulin.
  • Against psoriatic arthritis in HIV patients significantly increases the risk of opportunistic infections.

Features flow of reactive arthritis in HIV

  • Typically, these types of arthritis on a background of HIV infection due to undergoing chlamydia, salmonella, shigellosis and Yersinia infection.
  • Maximum severity of Reiter's syndrome is observed during the development of immunodeficiency (with AIDS), and is often accompanied by erosive and destructive changes in the joints.
  • particularly characteristic combination of urethritis and arthritis, as well as the appearance of dactylitis and atypical enthesopathies (such as inflammation of the Achilles tendon and plantar fascia), changes in the skin and nails.
  • At the same time in this pathology defeat of the mucous membranes and the spine is rare, and the specific features of HIV-associated synovitis been identified.

Peculiarities of undifferentiated spondyloarthropathies HIV

Characterized by extremely diverse localization changes: may be affected several joints (oligoarthritis), spine (spondylitis), dactylitis, atypical enthesopathies, says involvement in the process of mucous oral cavity, the genital tract, developeye disease (uveitis), broken nails (onycholysis).

According to scientists, a large role in this is directly affected by HIV joint tissues, as well as disorders of the immune processes due to infection.

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