Jen-Jia Yang1, Mao-Song Tsai1, Hsin-Yun Sun1, Szu-Min Hsieh1, Mao-Yuan Chen1, Wang-Huei Sheng2, Shan-Chwen Chang1. 1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan. 2. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan. Electronic address: whsheng@ntu.edu.tw.
Abstract
BACKGROUND: Autoimmune diseases-related arthritis has been rarely reported in HIV-1-infected patients. We aimed to investigate the incidence and clinical manifestations of autoimmune diseases-related arthritis in HIV-infected patients in the era of highly active antiretroviral therapy (HAART) in Taiwan. METHODS: We retrospectively reviewed medical records of all HIV-infected patients who had a diagnosis of autoimmune arthritis between 1993 and 2013. Demographic characteristics, clinical manifestations, serial CD4 and CD8 lymphocyte counts and plasma HIV viral loads, HLA-B27 status, and treatment response to HIV and rheumatic diseases were recorded. RESULTS: During the 20-year study period, totally 26 HIV-infected patients with autoimmune arthritis (0.7%) were diagnosed among 3623 HIV-infected patients. There were 18 patients with ankylosing spondylitis (AS), six with rheumatoid arthritis (RA), one with psoriatic arthritis, and one with Sjögren's syndrome. HLA-B27 antigens were all detected positive of AS patients. Fifteen patients (57.7%) developed autoimmune arthritis after HAART was initiated. The median age and CD4(+) T lymphocyte counts at the diagnosis of autoimmune arthritis were 35 (20-62 years) and 406 (3-695 cells/μL), respectively. Three patients had typical presentations of Reiter's syndrome. Both AS and RA patients achieved a good virological response with undetectable plasma HIV RNA load 12 months after receiving HAART(85.71% vs. 80%, respectively, p = 0.999). The treatment response to antirheumatic medications were similar between AS patients and RA patients (77.8% vs. 50%, p = 0.3068), but seems to be better than that reported for the general population (30-40%). CONCLUSION: A low prevalence of autoimmune arthritis among HIV-infected patients in the era of HAART was similar to that of the general Taiwanese population. Clinical manifestations of HIV-infected patients were similar to those described in HIV-uninfected patients. However, the treatment response to antirheumatic agents was better in HIV-infected patients in our study.
BACKGROUND:Autoimmune diseases-related arthritis has been rarely reported in HIV-1-infectedpatients. We aimed to investigate the incidence and clinical manifestations of autoimmune diseases-related arthritis in HIV-infectedpatients in the era of highly active antiretroviral therapy (HAART) in Taiwan. METHODS: We retrospectively reviewed medical records of all HIV-infectedpatients who had a diagnosis of autoimmune arthritis between 1993 and 2013. Demographic characteristics, clinical manifestations, serial CD4 and CD8 lymphocyte counts and plasma HIV viral loads, HLA-B27 status, and treatment response to HIV and rheumatic diseases were recorded. RESULTS: During the 20-year study period, totally 26 HIV-infectedpatients with autoimmune arthritis (0.7%) were diagnosed among 3623 HIV-infectedpatients. There were 18 patients with ankylosing spondylitis (AS), six with rheumatoid arthritis (RA), one with psoriatic arthritis, and one with Sjögren's syndrome. HLA-B27 antigens were all detected positive of AS patients. Fifteen patients (57.7%) developed autoimmune arthritis after HAART was initiated. The median age and CD4(+) T lymphocyte counts at the diagnosis of autoimmune arthritis were 35 (20-62 years) and 406 (3-695 cells/μL), respectively. Three patients had typical presentations of Reiter's syndrome. Both AS and RApatients achieved a good virological response with undetectable plasma HIV RNA load 12 months after receiving HAART(85.71% vs. 80%, respectively, p = 0.999). The treatment response to antirheumatic medications were similar between AS patients and RApatients (77.8% vs. 50%, p = 0.3068), but seems to be better than that reported for the general population (30-40%). CONCLUSION: A low prevalence of autoimmune arthritis among HIV-infectedpatients in the era of HAART was similar to that of the general Taiwanese population. Clinical manifestations of HIV-infectedpatients were similar to those described in HIV-uninfectedpatients. However, the treatment response to antirheumatic agents was better in HIV-infectedpatients in our study.
Authors: Aalia Bano; Alejandra Pera; Ahmad Almoukayed; Thomas H S Clarke; Sukaina Kirmani; Kevin A Davies; Florian Kern Journal: F1000Res Date: 2019-03-25