Human Immunodeficiency Virus Infection Search for Musculoskeletal Manifestations and Mimicking of Rheumatologic Disorders

This study involved 50 human immunodeficiency virus (HIV)-positive patients in various stages of the disease to identify signs and symptoms suggestive of rheumatologic disorders and to determine how frequently such findings mimic rheumatologic pictures. Control subjects were 25 ambulatory HIV-negative patients with similar risk factors, mostly drug abuse. Although arthralgias and myalgias were reported in both groups, arthritis was only detected in the HIV-positive group. Twenty-four HIV cases presented two or more signs or symptoms suggestive of rheumatic disorders versus only six non-HIV cases (p < 0.04). Some features were suggestive of systemic lupus erythematosus, vasculitis-panarteritis nodosa, Sjogren's syndrome, Behcet's syndrome and rheumatoid arthritis, although no patients met criteria for these diseases. Reiter's syndrome was diagnosed in two (4%) HIV-positive patients. On correlating CD4 lymphocyte levels and rheumatic symptomatology, the more severely immunocompromised cases were found to present musculoskeletal manifestations with greater frequency. Potential HIV infection should be considered in differential diagnosis of questionable cases of rheumatic disease to avoid both misdiagnosis and the institution of therapies liable to worsen the immunodeficiency syndrome.