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Hand osteoarthritis (HOA) is a heterogeneous disease with the involvement of different joints and varying levels of symptoms. Recent studies showed that the prevalence of HOA varied with gender, age and different hand joints.1–3 Different prevalence and longitudinal course of radiographic, erosive and symptomatic HOA were also described in the general population.2 Nevertheless, the accurate influence factors of HOA prevalence are still far from well understood. We read with deep interest the article by Anne-Laurence Tomi et al4 related to the prevalence and severity of radiographic HOA in patients with HIV-1 infection associated with metabolic syndrome. This cross-sectional Metabolic Syndrome and Fibrosis–Osteoarthritis (METAFIB-OA) study suggested that HOA frequency was greater in patients with HIV-1 infection than the general population, and it was more significant in those with metabolic syndrome (MetS). Thus, the authors thought that HIV-1 infection represents a special promotion for radiographic HOA and that there should be a ‘HIV-related OA’ subtype beyond classical OA phenotypes. We really appreciate the work that has been done by …