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Objectives: To determine the impact of human immunodeficiency (HIV) infection on rheumatoid arthritis (RA) disease activity. Patients & Methods: Retrospective record review of RA patients who HIV sero-converted, compared to a HIV negative RA control group. DAS28-ESR and -CRP scores were collected at the initial presentation (T0), time when HIV diagnosis made (TH) and the last clinic visit (TL). Results: Forty three HIV positive RA patients were included. At TL disease activity was similar between the groups, despite methotrexate (MTX) being continued in only 11.6% of the HIV group (vs. 83.7% in the control group, p=0.0002). In the HIV group, all clinical parameters improved except the ESR, which accounted for the significantly higher DAS28-ESR compared to the DAS28-CRP at TL (p=0.004). At TL only 13.9% HIV patients had ongoing moderate to high disease activity. Conclusion: Overall disease activity improved with HIV seroconversion in spite of stopping MTX in the majority of patients. The DAS28-ESR overestimated disease activity compared to DAS28-CRP following HIV seroconversion. |
