Journal Article

Osteonecrosis Complicating Highly Active Antiretroviral Therapy in Patients Infected with Human Immunodeficiency Virus

Paul Monier, Kevin McKown and Michael S. Bronze

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 6, pages 1488-1492
Published in print December 2000 | ISSN: 1058-4838
Published online December 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/317503
Osteonecrosis Complicating Highly Active Antiretroviral Therapy in Patients Infected with Human Immunodeficiency Virus

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Few patients with osteonecrosis that complicates human immunodeficiency virus (HIV) infection have been reported. We describe 5 patients whose symptoms of osteonecrosis developed with viral suppression and improvement in CD4 lymphocyte counts as a result of antiretroviral therapy. In addition, we review previously reported cases. The mean patient age was 35 years, and HIV was the sole risk factor in only 33%. Eighteen patients (55%) were receiving antiretroviral treatment when osteonecrosis was diagnosed. For 16 patients whose CD4 lymphocyte counts were reported, the mean CD4 count was 350 cells/mm3. In 10 of these patients, the occurrence or worsening of symptoms of osteonecrosis appeared to be related to successful antiretroviral therapy. We conclude that osteonecrosis is an emerging manifestation of HIV infection and that it may be either a consequence of immunologic and virologic improvement resulting from antiretroviral therapy or a complication caused by the drugs themselves.

Journal Article.  3501 words. 

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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