Alteraciones osteoarticulares en la infección por el VIH

Translated title of the contribution: Musculoskeletal disorders in hiv-infected patients

Rosa Polo*, Eugenia Negredo, Francisco Javier Pascua, Vicente Estrada, Juan Flores, M. José Galindo, Jesús Alberto García Vadillo, Félix Gutiérrez, Jaime Locutura, Rebeca Longueira Suárez, Ana Mariño, Antonio Ocampo, Pablo Rojo, Laura Capa, Inmaculada Gisbert, Hernando Knobel, María José Mellado, Jesús Sanz

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

The aim of this paper is to present the most relevant musculoskeletal disorders, their diagnosis and treatment to the scientific community and the professionals in charge of patients with human immunodeficiency virus (HIV) infection. These recommendations have been agreed by a panel of experts from the National AIDS Plan (PNS) and the AIDS Study Group (GESIDA). The group have reviewed the efficacy and safety results of clinical trials, cohort studies and pharmacokinetic studies published in biomedical journals (PubMed and Embase), or presented at conferences. Three levels of evidence have been defined according to the sources of data: level A, randomized controlled trials; level B, cohort or case-control; and level C, descriptive studies and expert opinion. Based on this evidence, the authors have decided to recommend, consider or not recommend for each situation. The decrease in bone mineral density is common in HIV-infected patients on antiretroviral treatment, especially during the first year (from 2 to 4%), with a subsequent partial recovery. A dual energy x-ray absorptiometry (DEXA) scan is recommended in patients over 50 years old with HIV infection, history of bone fractures and/or risk factors. Treatment with bisphosphonates has been shown to be effective. Osteoarticular infections are more frequent than in the non-infected population. The level of immunosuppression, risk practice, and antiretroviral treatment should be considered for a proper diagnosis and therapeutic approach. Laboratory and imaging procedures recommended for the study of musculoskeletal processes in HIV infected subjects are the same as in the general population. Osteonecrosis and decreased bone mineral density are the most frequent alterations in children. An early diagnosis of bone disorders is needed. The influence of modifiable risk factors must be avoided and initiate treatment when necessary. Bisphosphonates have been effective in osteoporosis.

Translated title of the contributionMusculoskeletal disorders in hiv-infected patients
Original languageSpanish
Pages (from-to)515-523
Number of pages9
JournalEnfermedades Infecciosas y Microbiologia Clinica
Volume29
Issue number7
DOIs
Publication statusPublished - Aug 2011

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