Concise report
Human immunodeficiency virus associated spondyloarthropathy:
pathogenic insights based on imaging findings and response to highly
active antiretroviral treatment
D McGonaglea, S Readea, H Marzo-Ortegaa, W Gibbonb, P O'Connorb, A Morgana, R Melsomc, E Morgand, P Emerya
a Rheumatology and
Rehabilitation Research Unit, University of Leeds, 36 Clarendon Road,
Leeds LS2 9NZ, UK, b Department of Radiology, The Leeds General
Infirmary, Great George Street, Leeds LS1
3EX, UK, c Rheumatology
Department, St Luke's Hospital, Little Horton Lane, Bradford BD5
0NA, UK, d Department of
Genitourinary Medicine, St Luke's Hospital, Little Horton Lane,
Bradford BD5 0NA, UK
Correspondence to: Professor Emery
Accepted for publication 26 September
2000
The pathogenesis of human immunodeficiency virus (HIV)
associated spondyloarthropathy (SpA) is poorly understood. In this case report a patient is described with severe HIV associated reactive
arthritis, who on magnetic resonance imaging and sonographic imaging of
inflamed knees had extensive polyenthesitis and adjacent osteitis. The
arthritis deteriorated despite conventional antirheumatic treatment,
but improved dramatically after highly active antiretroviral treatment,
which was accompanied by a significant rise in CD4 T lymphocyte counts.
The implications of the localisation of pathology and effect of
treatment for pathogenic models of SpA and rheumatoid arthritis in the
setting of HIV infection are discussed.
© 2001 by Annals of the Rheumatic Diseases
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