OSTEOARTICULAR INFECTION IN INTRAVENOUS DRUG-ABUSERS - INFLUENCE OF HIV-INFECTION AND DIFFERENCES WITH NONDRUG ABUSERS

Objectives-To determine (a) the influence of HIV in developing osteoar ticular infections in intravenous drug abusers (IVDAs) and (b) the dif ferences between the clinical features of osteoarticular infections in IVDAs and a control group of non-IVDAs. Methods-A comparative study o f the clinical features of osteoarticular infections in all HIV positi ve and HIV negative IVDAs admitted to the departments of rheumatology and internal medicine during a 10 year period was carried out. The joi nt infections of all IVDAs, irrespective of HIV status, were compared with those of a control group of non-IVDAs lacking risk factors for HI V infection. Results-A total of 482 HIV positive and 85 HIV negative I VDAs was studied, in whom 25 (5%) and six (7%) osteoarticular infectio ns were found respectively. There were no differences in age, sex, joi nts affected, and causative agents between these two groups. A compari son of the 31 (5.5%) osteoarticular infections in all IVDAs with 21 in fections in 616 (3.4%) non-IVDAs showed significant differences in the mean age (27.5 v 54), the frequency of affection of the axial joints (hip, sacroiliac, and sternocostal joints) (64.5% v 16.6%), and in the incidence of Candida albicans (19% v 0%). Conclusions-(1) HIV may not predispose to osteoarticular infections in IVDAs. (2) The hip, sacroi liac, and sternocostal joints (axial joints) were most commonly affect ed in IVDAs. (3) In Spain, unlike other countries, Gram positive bacte ria and C albicans seem to be predominant agents in osteoarticular inf ections in IVDAs, with a low incidence of Gram negative bacteria.