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XUAN ZHANG, HONGBIN LI, TAISHENG LI, FENGCHUN ZHANG, and YANG HAN
ABSTRACT. Methods. Ninety-eight consecutive inpatients with HIV infection admitted to Peking Union Medical College Hospital from 1999 to 2006 were studied. Demographic data, routes of transmission, clinical features, and laboratory findings were collected and a database was established. Laboratory studies included blood CD3+, CD4+, CD8+, CD19+, CD16+CD3+, CD4+CD28+, CD8+CD28+, HLA-DR+CD8+, and CD8+CD38+ lymphocyte counts, and antinuclear antibody tests. Hepatitis C virus (HCV) infection was also investigated in each patient. Risk factors for the rheumatic manifestations of HIV infection were assessed by logistic regression analysis. Results. Rheumatic manifestations were found in 53 (54.08%) HIV patients. Vasculitis was the most common finding (20 cases; 20.41%), including 15 cases of Behçet-like disease, 2 cases each of Henoch-Schönlein purpura and digital gangrene, and one case of central nervous system vasculitis. Other common rheumatic manifestations included Sjögren-like syndrome/diffuse infiltrative lymphocytosis syndrome (DILS; 11 cases; 11.22%), lupus-like syndrome (10 cases; 10.20%), of which 5 cases had renal involvement, and myositis (8 cases; 8.16%) including one case of zidovudine-induced myositis. No case of spondyloarthropathy was observed. Logistic regression analysis showed that Centers for Disease Control CD4+ T cell staging, erythrocyte sedimentation rate, and HCV infection were risk factors for HIV patients to develop rheumatic manifestations [p = 0.01, odds ratio (OR) = 31.80; p = 0.02, OR = 2.93; p = 0.01, OR = 17.47, respectively]. Conclusion. Rheumatic disorders such as vasculitis, Sjögren-like syndrome/DILS, lupus-like syndrome, and myositis were common in Chinese patients with HIV, while articular disorders were rare. CD4+ T cell depletion and HCV coinfection may predispose patients with HIV to develop rheumatic manifestations. (First Release July 15 2007; J Rheumatol 2007;34:1760-4) Key Indexing Terms:
HUMAN IMMUNODEFICIENCY VIRUS
From the Department of Immunology and Rheumatology and the Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China. X. Zhang, MD, Professor; H. Li, MD, PhD; F. Zhang, MD, Professor, Chief, Department of Rheumatology and Immunology; T. Li, MD, Professor, Chief; Y. Han, MD, PhD, Department of Infectious Diseases, Peking Union Medical College Hospital. X. Zhang and H. Li contributed equally to this article. Address reprint requests to Prof. F. Zhang, Department of Rheumatology and Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China. E-mail: zhangsamfc@hotmail.com Accepted for publication February 19, 2007. |
