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Increased prevalence and severity of radiographic hand osteoarthritis in patients with HIV-1 infection associated with metabolic syndrome: data from the cross-sectional METAFIB-OA study
  1. Anne-Laurence Tomi1,2,
  2. Jérémie Sellam1,3,
  3. Karine Lacombe4,5,
  4. Soraya Fellahi3,6,
  5. Manuela Sebire5,
  6. Caroline Rey-Jouvin1,
  7. Anne Miquel7,
  8. Jean-Philippe Bastard3,6,
  9. Emmanuel Maheu1,
  10. Ida K Haugen8,
  11. David T Felson9,
  12. Jacqueline Capeau3,6,
  13. Pierre-Marie Girard4,5,
  14. Francis Berenbaum1,3,
  15. Jean-Luc Meynard5
  1. 1Department of Rheumatology, DHU i2B, Saint-Antoine Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France
  2. 2Department of Rheumatology, Henri Mondor Hospital, AP-HP, Créteil, France
  3. 3Sorbonnes Universités, UPMC University Paris 06, INSERM UMRS_938, DHU i2B, Paris, France
  4. 4Sorbonnes Universités, UPMC University Paris 06, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
  5. 5Department of Infectious Diseases, Saint-Antoine Hospital, AP-HP, Paris, France
  6. 6Biochemistry Department, Tenon Hospital, AP-HP, Sorbonnes Universités, UPMC University Paris 06, INSERM UMR_S938, DHU i2B, IHU ICAN, Paris, France
  7. 7Department of Radiology, Saint-Antoine Hospital, AP-HP, Paris, France
  8. 8Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  9. 9Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Professor Francis Berenbaum, Department of Rheumatology, Saint-Antoine Hospital, 184 rue du Faubourg, Saint-Antoine, Paris 75012, France; francis.berenbaum{at}


Objective To determine radiographic hand osteoarthritis (HOA) prevalence in patients with HIV-1 infection in comparison with the general population and to address whether metabolic syndrome (MetS) may increase the risk of HOA during HIV-1 infection.

Patients Patients with HIV-1 infection and MetS (International Diabetes Federation, IDF criteria) aged 45–65 years were matched by age and gender to HIV-1-infected subjects without MetS and underwent hand radiographs. Framingham OA cohort was used as general population cohort.

Methods Radiographic HOA was defined as Kellgren–Lawrence (KL) score ≥2 on more than one joint. Radiographic severity was assessed by global KL score and number of OA joints. HOA prevalence was compared with that found in the Framingham study, stratified by age and sex. Logistic and linear regression models were used to determine the risk factors of HOA in patients with HIV-1 infection.

Results 301 patients (88% male, mean age 53.4±5.0 years) were included, 152 with MetS and 149 without it. Overall, HOA prevalence was 55.5% and was higher for those with MetS than those without it (64.5% vs 46.3%, p=0.002). When considering men within each age group, HOA frequency was greater in patients with HIV-1 infection than the general population (all ages: 55.8% vs 38.7%; p<0.0001), due to the subgroup with MetS (64.9%; p<0.0001), as well as the subgroup without MetS, although not significant (46.6%; p=0.09). Risk of HOA was increased with MetS (OR 2.23, 95% 95% CI 1.26% to 3.96%) and age (OR 1.18, 95% CI 1.12 to 1.25). HOA severity was greater for patients with MetS than those without. HOA was not associated with previous or current exposure to protease inhibitors or HIV infection-related markers.

Conclusions HOA frequency is greater in patients with HIV-1 infection, especially those with MetS, than the general population.

Trial registration number NCT02353767.

  • Osteoarthritis
  • Hand Osteoarthritis
  • Infections

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  • Handling editor Hans WJ Bijlsma

  • A-LT, JS, FB and J-LM contributed equally.

  • Correction notice This article has been corrected since it was published Online First. The title of the study in the first sentence of the Methods/Patients section has been corrected.

  • Contributors All authors fulfil the following four criteria: (1) substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work; AND (2) drafting the work or revising it critically for important intellectual content; AND (3) final approval of the version to be published; AND (4) agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding NIH AR47785 for Framingham cohort access and Bristol Myer Squibb (BMS) that financially supported the assessment of biomarkers but was not involved in the analysis of the study or interpretation of the results. All coauthors are independent of these funding sources.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Comité de Protection des Personnes, Paris Ile de France V, Paris.

  • Provenance and peer review Not commissioned; externally peer reviewed.