Apr 16, 2004
I read alot of your letters on joint pain .Why do you rule out the drugs when they have joint pain as a side effect like Ziagen in 5 to 9 % of paitents had joint pain also most long term survivers seem to be have these symtoms Could the disease and or drugs excelerate arthritis or could the drugs and or the disease just be eating away at the bones and joints Thank you
Response from Dr. Henry
Good question. Joint pain is very common in the general population and increases as people get older. Joint pain is reported in many studies including in the placebo arms of HIV drug trials. Reporting joint pain in the setting of HIV treatment does not necessarily link the treatment to the pain. In my primary care days prior to my involvement in HIV (1978-1984) I saw hundreds of patients with joint pain that were not HIV infected. It is my impression now that I have personally cared for hundreds of HIV infected persons for nearly 20 years that most of their joint pain (when they experience it)is not related to their HIV drugs. Their are some HIV related arthritis like conditions (Reiters), bone conditions that the drugs may contribute to (such as osteoporosis, aseptic necrosis), but very few discrete forms of arthritis that seem linked to specific HIV drugs. I share a hall-way with the rheumatology service where I work so I often get help with my patients joint symptoms which is beneficial to the patients and helps me keep on what is happening in the rheumatology world. KH
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