Manifestaciones reumatológicas en pacientes con síndrome de inmunodeficiencia adquirida (VIH/SIDA) / Rheumatic manifestations in patient with human immunodeficiency virus infection

ABSTRACT

HIV infection produces a state of alteration in the immune system that not only increases the susceptibility to infections and tumors, but also leads to autoimmune conditions such as those found in rheumatology. These patients manifest a greater frequency of polyarthritis, pelvic spondylopathy, Sjõgren’s syndrome, myopias, and certain vasculitis. On the other hand, there is a great harboring and overexposure of symptoms among systemic autoimmune diseases (e.g. systemic lupus erythematosus, vasculitis), as well as HIV itself, which together with a greater frequency of autoantibodies in these patients, can frequently make differential diagnosis quite difficult. It is important to know about the existence of exclusive autoimmune manifestations, such as the diffuse infiltrative lymphocytosis syndrome, characterized by parotid hypertrophy, intestinal pneumonia and myopathy. However, new rheumatic conditions have appeared with the use of the highly successful antiretroviral therapy, whether caused by adverse reactions to drugs (myopathies, arthritis,neuropathologies) or within the context of the immune reconstitution syndrome, in which reactions such as sarcoidosis, the appearance or exacerbation of a preexisting rheumatoid arthritis and Graves disease, among others, have been described. Knowing the interrelation between autoimmune pathologies and HIV is important for the adequate diagnosis of both types of conditions and may provide information as to immunopathogenicity of both diseases.