Distribution of autoantibodies and rheumatological manifestations in HIV-positive patients from the University Clinic of Bonn – a pilot study

Purpose of the study

In literature an association between HIV-infection and the increased occurrence of autoantibodies has been reported. The relation between autoantibodies and rheumatological disease manifestations, however, remains uncertain. The objective of this study is to assess rheumatologic manifestations and prevalence of autoantibodies in a cohort of HIV-positive individuals and to correlate these findings with HIV-specific disease parameters under receipt of HAART.

Methods

Documentation of clinical symptoms of autoimmune disease in 64 HIV-positive patients treated in the University Clinic of Bonn. Screening of autoantibodies includes rheumatoid factor, ANA, ANCA, cardiolipine antibodies, thyroid antibodies and microsomal antibodies.

Summary of results

Twenty-one of 64 patients reported muscular or joint-related complaints. None of the patients, however, revealed sufficient ACR criteria for the diagnosis of rheumatoid arthritis. No correlation was found between muscular and/or joint pain and the detection of any kind of autoantibodies. In addition there was no correlation between CD4-count, CDC-stage or level of HIV-viremia and positivity of autoantibodies. A correlation was found, however, between CD4-count and IgG-level (p = 0.015; OR = 0.997). No correlation was found between co-infection (hepatitis, STD) in general and presence of autoantibodies (p = 0.852; OR = 1.267; confidence interval = 0.106–15.193). Also, no correlation was found between occurrence of autoantibodies and the receipt of HAART (p = 0.725; OR = 0.376; confidence interval = 0.002–86.851).

Conclusion

The presence of joint or muscle pain was high with 32.81% expressing corresponding complaints. Also, the prevalence of autoantibodies was higher than in the general population with 18.97%. In this small group of patients, however, no correlation was found between HIV disease stage markers and the occurrence of rheumatological disease manifestations or presence of autoantibodies.