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In order to assess the frequency of rheumatologic manifestations at different stages of pediatric human immunodeficiency virus (HIV) infection, 26 HIV-infected children at any stage of infection, seen at the Children's AIDS Clinic of "La Raza" National Medical Center from January 1997 to December 1998, were studied. Rheumatologic manifestations were assessed following the criteria established by the American College of Rheumatology. Blood samples were taken for measuring CD4+ and CD8+ T cells, antinuclear antibodies (ANA), anticardiolipin (ACL) antibodies, and rheumatoid factor (RF). The results were compared to those of 25 HIV-negative children of similar ages. Rheumatologic manifestations were identified in 5 (19.2%) of 26 children. Two of whom were twin sisters with biphasic Raynaud's syndrome, and one had necrosing vasculitis of a finger, as well as lip necrosis and livedo reticularis. These patients were positive for ANA and ACL. One case each of knee arthalgias, vasculitis, and septic arthritis of the ankle were also seen. All of the rheumatologic manifestations were in advanced stages of HIV disease. These rheumatologic changes are similar to those reported for HIV-positive adults, and should be considered as part of the HIV acquired immune deficiency syndrome (AIDS) clinical spectrum in the pediatric population.

Objective: Assess the impact of human immunodeficiency virus (HIV) infection on the onset of rheumatic manifestations in HIV+ patients, and to compare them with a control HIV- group with similar risk factors., Methods: We prospectively studied 74 consecutive HIV+ patients, looking for clinical and laboratory findings of rheumatic manifestations and compared them with 72 control subjects with similar risk factors for HIV who tested negative for HIV., Results: Rheumatic manifestations were more frequently observed in the HIV+ group than the HIV-group (p < 0.001): Arthralgias were found in 34 (45%), arthritis in 8 (10%), and Reiter's syndrome in 6 (8%). Laboratory findings revealed rheumatoid factor in 16 (21%) HIV+ vs 2 (2%) in HIV-, antinuclear antibodies in 13 (17%) HIV+ vs 0 in HIV-, IgG anticardiolipin antibodies in 70 (94%) HIV+ vs 7 (9%) in HIV- (p < 0.001). Hyperuricemia was found in 31 HIV+ patients (41%), and hypouricemia in 4 (5%), compared with none in the HIV- group (p < 0.0001). Neoplasia were identified in 13 HIV+ patients, in 7 associated with hyperuricemia and 3 with hypouricemia. Of interest, 2 patients had urate abnormalities before the diagnosis of neoplasia., Conclusions: Our study suggests that rheumatic manifestations are more prevalent in HIV+ patients. In advanced HIV infection, hypo and hyperuricemia may be considered markers of neoplasia.