ACUTE ARTHRITIS AND HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION IN RWANDA

Objective. To determine the etiology of acute arthritis observed in ad ults and to define its relationship with human immunodeficiency virus 1 (HIV-1) infection in Kigali, capital city of Rwanda. Methods. From S eptember 1, 1989 until March 31, 1990 we conducted a study of all new patients admitted with acute arthritis to the outpatient and inpatient services of the Department of Internal Medicine at the Centre Hospita lier de Kigali, in Kigali, Rwanda, a city highly endemic for HIV infec tion. Results. Thirty-six patients (27 men 9 women; mean age: 31 years , range 18-65) were included in the study. Twenty-six (72 %) were HIV seropositive. Two main diagnostic categories emerged, both strongly as sociated with HIV infection: (1) aseptic arthritis: 16 (44.5 %) patien ts including 12 (33.5 %) patients with spondyloarthropathy of whom 10 (83 %) were HIV seropositive, and 4 (11 %) patients with HIV related a rthritis, (2) septic arthritis: 11 (30 %) patients of whom 9 (82 %) we re HIV seropositive, including 4 with gonococcal, 2 with staphylococca l, 1 with Salmonella B and 2 with tuberculous arthritis. Conclusion. I n an area highly endemic for HIV, acute arthritis should be considered a possible manifestation of HIV infection and should prompt HIV testi ng.