Rheumatological and Immunological Manifestations among a Cohort of Human Immunodeficiency Virus Egyptian Patients
Dalia Fayez Mohamed, Sherin Mohamed Hosny, Safaa Abdelsalam Aly Hussein, Ayman Mohamed Hamed- General Medicine
Abstract
Background
The human immunodeficiency virus (HIV) is a lentivirus (a subgroup of retrovirus) that is able to persist in the form of integrated proviruses in a predominantly CD4 T cell reservoir causing HIV infection and over time acquired immunodeficiency syndrome (AIDS).
Objective
Detection of frequency and pattern of rheumatological and immunological disorders in HIV infected Egyptian patients.
Patients and Methods
This study was observational cross sectional study conducted in tertiary hospital of infectious diseases in Giza, Egypt outpatient clinics and inpatient departments. It included one hundred human immune deficiency virus infected Egyptian patients diagnosed according to national AIDS program criteria having an immunological or a musculoskeletal disorder with age of ≥ 18 years.
Results
Results from our study which revealed a highly significant correlation between both CD4 count, HIV-PCR level and the incidence of oral ulcers. There was only a significant value between HIV-PCR level and the presence of myositis or thromboembolic manifestations. Within our 100 HIV positive patients the mean levels of ESR, CRP and SGOT levels were elevated. There was a weak inverse correlation between the CD4-positive lymphocyte count and ESR. There was a highly significant negative correlation between CD4 count and HIV infection duration ESR, CRP, urea, creatinine, blood urea level, SGOT, SGPT. Also, significant negative correlation between CD4 count and uric acid level. Moreover, there were a highly significant positive correlation between the HIVPCR level and ESR, CRP, serum creatinine level, SGOT and SGPT. There was a high significant negative correlation between the HIV-PCR level and hemoglobin level, platelets count and CD4 count. There was a significant negative correlation between HIV-PCR level and absolute lymphocyte count.
Conclusion
Rheumatologic manifestations are commonly occurring in HIV positive patients. Raynaud’s phenomenon, oral ulcers, and hepatosplenomegaly are significantly more prevalent in patients under non-HAART. ESR and CRP are significantly higher in patients not receiving HAART. Viral load is significantly higher in patients with non-specific antiviral treatment, while CD4 count is significantly lower in the same patient cohort. There is a significant relation between incidence of oral ulcers with lower CD4 count and higher viral load.