Human immunodeficiency virus-related connective tissue diseases: a Zimbabwean perspective
Davis, P.; Stein, M.
Rheumatic Diseases Clinics of North America 17(1): 89-97
1991
ISSN/ISBN: 0889-857X PMID: 2041891 Document Number: 317274
A review of patients presenting at the rheumatology clinic of the Parirenyatwa Hospital, University of Zimbabwe School of Medicine, revealed 14 with HIV infections. Over a 6-month period, 141 patients had been diagnosed with rheumatic diseases, including 49 with rheumatoid arthritis, 18 with systemic lupus erythematosus (SLE), 5 with dermatomyositis and 3 with scleroderma. Rheumatic diseases were thought to be rare in this population, of whom only 0.2% carry the HLA B27 antigen. Recently a marked increase in patients with reactive or Reiter-like illness, the most common arthropathy in HIV+ patients, were referred. These 14 patients, mostly males, all had acute onset arthropathy, 5 with polyarthritis and 9 with oligoarticular diseases, usually of the knees and ankles, usually symmetrical, or asymmetrical in the small peripheral joints. Synovial fluid was negative except for leukocytosis. The duration of the illness was usually 3-6 months. In addition there were 3 HIV+ patients with complete Reiter's and 7 HIV+ with incomplete Reiter's syndrome, out of a total of 16 Reiter's patients. Among the associated symptoms were urethritis, cervicitis, conjunctivitis, balanitis and oral ulceration, but not psoriasis. These patients had elevated sedimentation rates, but otherwise negative blood findings, other than anemia. In contrast 36 patients with rheumatoid arthritis and 12 with SLE were HIV-. 2 HIV patients also had septic arthritis, a common condition in Zimbabwe.