A review of the available literature was performed in order to summarize the pathogenic
and clinical connections between HIV infection and rheumatological syndromes. The increasing
life expectancy during human immunodeficiency virus (HIV) infection has led to the observation
of many rheumatological manifestations over the years in these types of patients. Although the
pathological mechanisms are still not fully understood, several rheumatological diseases have been
more commonly observed in the general population, especially after the advent of highly active antiretroviral
therapy (HAART), and sometimes clinical and serological findings are influenced by
the underlying condition which defines a characteristic onset or development of the disease. Autoimmune
diseases occur during specific stages of the HIV infection, depending on the underlying
pathogenic mechanism being mainly influenced by the CD4+ cells count. Several rheumatological
diseases show peculiar clinical manifestations influenced by the underlying HIV infection leading
to specific features less commonly observed in the healthy population. Conversely to pathological
findings, broadly, HIV-1-neutralizing antibodies (BnAb) observed in several autoimmune diseases,
such as SLE, could play a protective role in HIV infection. It is important to evaluate the onset of
autoimmune diseases in HIV patients in order to start the appropriate treatment to avoid harmful
events. More studies are needed to enlighten the trend of autoimmune diseases during HIV infection.
Pathogenic mechanisms and clinical manifestations of rheumatological diseases during HIV
infection are discussed in this review.
Keywords: HIV, AIDS, HAART, autoimmune, rheumatology, arthritis.
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