Human immunodeficiency virus-associated polymyositis: A longitudinal study of outcome

Randall W. Johnson, Francis M. Williams, Salahuddin Kazi, Mazen M. Dimachkie, John D. Reveille

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Objective. To determine the clinical course and optimum treatment of human immunodeficiency virus (HIV)-associated myositis. Methods. Sixty-four patients attending a county outpatient HIV/acquired immunodeficiency syndrome facility were referred for the presence of elevated creatine kinase (CK) levels or muscle weakness. Patients underwent neurologic and rheumatologic evaluation, electromyography, and muscle biopsy after exclusion for recreational drug or alcohol use, metabolic/endocrine disorders, zidovudine therapy, and other infections. Results. Thirteen patients (20%) had biopsy-proven myositis. The median duration of HIV infection prior to diagnosis of myositis was 4.3 years (range 0-11 years). Six patients had concomitant diffuse infiltrative lymphocytosis syndrome. There was no correlation of severity of weakness, stage of HIV infection, or retroviral treatment with the CK level at diagnosis. Eight patients received prednisone (60 mg/day) with 5 attaining complete resolution of myositis. The remaining 3 patients received immunosuppressive therapy (azathioprine or methotrexate and intravenous immunoglobulin) and had normalization of strength and CK. Four patients had spontaneous resolution of their myositis without treatment. Conclusion. HIV-associated myositis occurs at any stage of HIV infection, has a relatively good prognosis, responds well to immunosuppressive therapy, and has little evidence of adverse outcome on the HIV infection.

Original languageEnglish (US)
Pages (from-to)172-178
Number of pages7
JournalArthritis Care and Research
Volume49
Issue number2
StatePublished - Apr 15 2003

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Polymyositis
Myositis
Longitudinal Studies
HIV
Virus Diseases
Creatine Kinase
Immunosuppressive Agents
Therapeutics
Biopsy
Lymphocytosis
Zidovudine
Intravenous Immunoglobulins
Muscle Weakness
Azathioprine
Street Drugs
Electromyography
Prednisone
Methotrexate
Nervous System
Acquired Immunodeficiency Syndrome

Keywords

  • HIV infection
  • Polymyositis
  • Prognosis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Johnson, R. W., Williams, F. M., Kazi, S., Dimachkie, M. M., & Reveille, J. D. (2003). Human immunodeficiency virus-associated polymyositis: A longitudinal study of outcome. Arthritis Care and Research, 49(2), 172-178.

Human immunodeficiency virus-associated polymyositis : A longitudinal study of outcome. / Johnson, Randall W.; Williams, Francis M.; Kazi, Salahuddin; Dimachkie, Mazen M.; Reveille, John D.

In: Arthritis Care and Research, Vol. 49, No. 2, 15.04.2003, p. 172-178.

Research output: Contribution to journalArticle

Johnson, RW, Williams, FM, Kazi, S, Dimachkie, MM & Reveille, JD 2003, 'Human immunodeficiency virus-associated polymyositis: A longitudinal study of outcome', Arthritis Care and Research, vol. 49, no. 2, pp. 172-178.
Johnson RW, Williams FM, Kazi S, Dimachkie MM, Reveille JD. Human immunodeficiency virus-associated polymyositis: A longitudinal study of outcome. Arthritis Care and Research. 2003 Apr 15;49(2):172-178.
Johnson, Randall W. ; Williams, Francis M. ; Kazi, Salahuddin ; Dimachkie, Mazen M. ; Reveille, John D. / Human immunodeficiency virus-associated polymyositis : A longitudinal study of outcome. In: Arthritis Care and Research. 2003 ; Vol. 49, No. 2. pp. 172-178.
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