Effect of Anti-Retroviral Therapy on the Prevalence and Pattern of Rheumatic Musculoskeletal Diseases amongst Human Immunodeficiency Virus Infected Patients in Zaria, North-Western Nigeria
Human immunodeficiency virus (HIV) infection remains a public health problem due to high rate of new infections, high disease prevalence, and the significant morbidity and mortality associated with the disease. Musculoskeletal system is commonly affected in HIV patients and rheumatic musculoskeletal diseases (RMDs) often contributes to the burden of HIV disease by increasing morbidity and mortality. Early and effective initiation of combine antiretroviral therapy (cART) have been shown to significantly reduce burden of disease in HIV infected individuals, thereby improving outcome and survival of patients. This cross-sectional study aims to ascertain the effect of ART on the overall prevalence and pattern of RMDs in Nigeria patients with HIV infection. Two hundred HIV-seropositive subjects and 200 age and gender matched HIV negative controls were recruited for the study. HIV positive patients were further grouped into 2:cART naive (100 patients) and cART-experienced (100 patients). All participants were screened for the presence of rheumatic disease, using a validated interviewer administered structured questionnaire. Rheumatologic diseases were diagnosed using the ACR criteria or other well validated classification criteria. Data were analyzed using SPSS 17.0 Rheumatologic disease was diagnosed in 56 (28%) HIV positive patients compared to 15 (7.5%) HIV negative control. Of the 56 HIV-positive patients diagnosed with rheumatic disease, 21(37.5%) were cART experienced and 35(62.5%) were ART naïve. The odds ratio for development of rheumatic disease was significantly less in patients on ART (OR=0.49, 95% CI= 0.26-0.93, P= 0.02) Point prevalence of rheumatic musculoskeletal diseases is lower in HIV patients on cART, and the usage of cART is associated with reduced odds of development of HIV associated rheumatic disease.
Copyright (c) 2019 Umar Abdul’aziz, Adelowo O. Olufemi, Sani B. Garko
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