Musculoskeletal considerations in HIV disease: A critical review

• Type of Material: Article
• Authors: Sara Pullen, Emory University
• Language: English
• Date: 2014
• Publisher: Open Access Publishing London
• Publication Version: Final Published Version
• Copyright Statement: © 2014 Pullen.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://www.oapublishinglondon.com/article/1565
• Title of Journal or Parent Work: OA Musculoskeletal Medicine
• ISSN: 2052-9287
• Volume: 2
• Issue: 2
• Research Categories: Biology, Virology; Health Sciences, Medicine and Surgery; Health Sciences, Rehabilitation and Therapy

Abstract

Introduction: The vast progress in management of HIV disease with anti-retroviral therapy (ART) in the past three decades has resulted in increased life expectancy for people living with HIV/AIDS. With this new chronicity of the disease has emerged a constellation of musculoskeletal impairments ranging from arthritis to traumatic fractures requiring orthopedic surgery. This manuscript aims to review and critique recent research (2009-2014) investigating musculoskeletal complications of HIV disease, and to propose future directions for management of such diagnoses. Methods: The literature reviewed was divided into the following categories, in order of publication date: general musculoskeletal complications arising from the HIV virus itself and/or ART, HIV-related bone infections and bone disease, rheumatic disease in HIV infection, vitamin D deficiency in HIV disease, and orthopedic post-surgical complications/risk factors resulting from HIV disease. Results: A total of 19 articles met the described inclusion criteria and were included in this critical review. From most recent (2014) to oldest (2009), 4 articles were published in 2014, 7 in 2013, 3 in 2012, 1 in 2011, 2 in 2010 and 2 in 2009. Discussion: While the pathophysiology of HIV-related musculoskeletal complications is well documented in the literature, it is crucial that attention is also focused on treatment. The complex nature of disability in PLWHA necessitates a multidisciplinary approach to treatment to adequately address the diagnostic and treatment needs of this population. Conclusion: Given the multitude of musculoskeletal complications that arise from the HIV virus and/or ART, research must be continuously conducted to assess risk, prevention and treatment. This research will need to focus on both non-surgical and surgical approaches to management of musculoskeletal complications in the HIV-infected individual.