RHEUMATIC MANIFESTATIONS IN HUMAN-IMMUNODEFICIENCY-VIRUS POSITIVE ANDNEGATIVE INDIVIDUALS - A STUDY OF 2 POPULATIONS WITH SIMILAR RISK-FACTORS

Objective. Assess the impact of human immunodeficiency virus (HIV) inf ection 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, look ing for clinical and laboratory findings of rheumatic manifestations a nd compared them with 72 control subjects with similar risk factors fo r HIV who tested negative for HIV. Results. Rheumatic manifestations w ere more frequently observed in the HIV + group than the HIV-group (p < 0.001): Arthralgias were found in 34 (45%), arthritis in 8 (10%), an d 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 O 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 o f neoplasia. Conclusions. Our study suggests that rheumatic manifestat ions are more prevalent in HIV + patients. In advanced HIV infection, hypo and hyperuricemia may be considered markers of neoplasia.