Can joints hurt with HIV? Treatment. HIV-associated arthritis: treatment methods and consequences Legs hurt with HIV what to do

IN Russian Federation, amid talk of the economic crisis, they completely forgot about HIV, an infection that has become an epidemic. According to Rospotrebnadzor, at the beginning of 2016, more than 980 thousand (!) people infected with the human immunodeficiency virus were registered in the Russian Federation.

HIV incidence rates

In 2015 alone, more than 20 thousand people died from AIDS in our country, which is 16% more than last year. The number of people infected in 2015 in our country exceeded 70 thousand, which is also more than 12% higher than last year’s figure.

The HIV incidence rate (number of cases per 100 thousand population) in the Novosibirsk region was 125 people last year, and in the country as a whole - 50.

So, for example, in Sverdlovsk region, which is the leader of sad statistics, per 100 thousand people there are 1511 (!) infected people, or 1.5% of the population.

In Russia, people are trying to fight a system that is silent about the HIV problem and are holding unique protests. The photo shows an example of such an action that recently took place in Moscow.

As before, the main route of infection for men is intravenous drug addiction, and for women it is through sexual intercourse with infected men.

The rapid deterioration of the epidemic situation with the spread of HIV infection in our country raises a number of serious issues, including turning to specialists regarding certain complaints from patients who have no idea that their body is infected with HIV.

Defeat nervous system with this chronic infection can occur in different ways:

• possibly as a primary lesion of the nervous system at the carrier stage;
• the appearance of neurological symptoms at the stage of AIDS, in which a person is affected by various infections,
• may be caused by the use of powerful antiviral, antifungal and antibacterial drugs for the treatment of opportunistic infections at the last stage of the disease.

Pain along the nerve trunks, which is neuralgic in nature, with the exception of any probable cause of an everyday, classical nature, if treatment is ineffective, must necessarily be considered as a probable manifestation of HIV infection, and it is advisable to persuade the patient, for the sake of his personal safety, to be examined for this virus.

About primary damage to the nervous system

While a person infected with HIV feels absolutely healthy, areas of demyelination (destruction of the insulating membrane of nerve processes in neurons) may form in his brain. – pathological process, which is selective damage to the myelin sheath that runs around the nerve fibers of the central or peripheral nervous system), which interfere with nerve conduction electrical impulses, causing a “short circuit”, as well as foci of encephalitis.

Clinical manifestations caused by the human immunodeficiency virus itself are as follows:

• Dementia (acquired dementia). Patients cease to be interested in life, initiative and self-criticism decline, they become unable to perform professional skills related to intelligence. Reaction speed decreases, emotional-volitional impoverishment develops. Patients become incapable of running a household, making financial payments, and strive to shift everything to their family. Speech becomes monosyllabic, interest in others decreases. Memory for current events decreases sharply. This dementia is capable of rapid progression, and, if it occurs at a young age, may indicate HIV infection.
• Myelopathy. At this stage, neuralgia, myalgia, and muscle pain may (rarely) occur due to damage spinal cord and the development of foci of demyelination in it. As a rule, strength and sensitivity in the legs are impaired, and an unsteady gait develops, which is impossible with closed eyes. The muscle tone in the legs increases, which may be accompanied by pain resembling neuralgia. In this case, disorders occur symmetrically, affecting both the left and right legs.
• Immediately after infection, the development of meningitis is possible, which is aseptic, and is based on the mechanisms of impaired immunity during the introduction of the virus and its reproduction. Meningitis is serous, but in addition to severe headache, some cranial nerves may be involved in the process, so it is possible to develop neuralgia, nerves that are not independent processes, but are associated with irritation of the meninges. Usually these phenomena disappear within 1 month, often without causing any particular suspicion either to the patient or to the doctors.
• The following syndrome of damage to the central nervous system during primary exposure to HIV can simulate neuralgia, neuropathic pain in a variety of areas, but again, the most common lesion is lower limbs. Characterized by excruciating, persistent, shooting pains, with impaired sensitivity in the toes, and the appearance of paresthesia (numbness, crawling). In addition, increased muscle fatigue, muscle pain are characteristic, and involuntary muscle twitching is possible.

Treatment of these primary lesions is difficult and lengthy, since they are caused by the very primary effect of the virus on the human body. Treatment is carried out by an infectious disease specialist with the appointment of special expensive antiviral drugs(Retrovir, Invirase), which the patient must receive according to the federal quota.

How effective is timely therapy?

Considering that many processes during this period of development of neurological symptoms are of an autoimmune nature, the use of corticosteroid hormones and cytostatic drugs, immunomodulators (interferons, cytokine therapy), and plasmapheresis is indicated. Full treatment is very expensive.

However, despite all the timely therapy, if such primary disorders of the central and peripheral nervous system develop early stage infection, this indicates either a high activity of the virus or a low level of immunity, and is a prognostically unfavorable factor, indicating the possible early onset of the AIDS stage and the addition of secondary infections.

In addition to the effect of the virus, compression (or squeezing) of nerve trunks by pathologically overgrown lymphoid tissue is possible, since HIV infection is characterized by the development of specific lymphomas - tumors of lymphoid tissue.

At the AIDS stage, the immune system is so depressed that a person begins to suffer from many diseases: Pneumocystis pneumonia, Kaposi's sarcoma, tuberculosis, chronic bacterial and protozoal types of diarrhea, cryptococcal meningitis, progressive multifocal leukoencephalopathy, in which the myelin sheath of neurons is destroyed, lymphogranulomatosis, herpes virus infections.

At the AIDS stage, a person can be affected by systemic mycoses (candidal esophagitis) and Salmonella septicemia.

Finally, it is against the background of HIV infection that herpes zoster often occurs with the development of postherpetic neuralgia, which is difficult to treat and occurs with persistent and excruciating pain.

Therefore, everyone who cares about maintaining their health and the health of others needs to be tested for HIV.

Very often, the presence of the immunodeficiency virus in the body provokes the development of concomitant diseases. The most unpleasant symptoms arise with the development of AIDS. The fact that HIV has entered the active stage may be indicated by:

• elevated cholesterol levels;
• a large number of blood sugar;
• high blood pressure;
• increased triglyceride levels.

In rare cases, patients complain of pain in muscles and joints, swelling of the legs. Such reactions of the body are completely understandable and expected.

However, you need to understand that with HIV, swelling of the legs can occur due to factors independent of the virus (for example, poor nutrition, pregnancy, or kidney disease). But with AIDS, protein-free edema most often occurs, which is provoked by a lack of protein in the diet.

Causes of swelling of the legs with HIV

The immunodeficiency virus causes the human body to produce many antibodies, white cells, and circulating immune complexes that attack foreign organisms and affected tissues. Typically these antibodies only target infectious organisms, but with HIV they can also attack healthy tissue. For this reason, joint pain and swelling of the legs occur. Most often, edema (including protein-free edema) occurs in men over 50 years of age who have necrotizing retinitis and regularly take Kaletra.

Treatment and prevention of leg swelling due to AIDS

Treatment of protein-free edema in AIDS is carried out with non-steroidal anti-inflammatory drugs. medicines, such as ibuprofen or naproxen.

But if swelling of the patient’s lower extremities is accompanied by shortness of breath, then prevention of heart failure and anemia is necessary. A diuretic (for example, furosemide, no more than 40 mg per day) will help. If protein-free edema is accompanied by exhaustion, then the patient is prescribed a blood transfusion, namely red blood cells.

At the moment, the connection between antiviral drugs and edema has not been officially confirmed. Therefore, there are no special prevention methods for HIV-infected people. However, immediately after swelling occurs, you need to consult a doctor who will adjust the course of antiviral drugs and try to eliminate the problem. You will also have to stop taking oral contraceptives, any synthetic hormones, calcium channel blockers, antidepressants and MAO inhibitors, which are often prescribed to AIDS patients.

Viral arthritis - inflammatory diseases joints caused by viral infection.

Most often, viral arthritis is caused by rubella viruses, hepatitis B and C, human immunodeficiency (HIV), parvovirus B 19, alpha viruses, less commonly measles viruses, smallpox viruses, enteroviruses, adenoviruses, herpes viruses, human T-lymphotropic virus type I.

Atritis due to rubella

Diagnostic signs

arthritis occurs with rubella infection in 50% of adult women and 6% of adult men, less often in children;

arthritis most often develops simultaneously with a generalized maculopapular rash, less often - a few days before the rash;

the joints of the wrist, small joints of the hands (proximal and distal interphalangeal joints), and much less often the knee and elbow joints are affected;

Tenosynovitis is typical, and carpal tunnel syndrome may develop;

arthritis is manifested by pain, swelling, redness of the skin in the area of ​​the affected joints, and disruption of their function;

joint damage is usually bilateral, often asymmetrical;

arthritis is accompanied by lymphadenopathy;

arthritis usually reverses within 2-3 weeks;

X-rays of the joints reveal no pathological changes.

Laboratory data

Complete blood count: leukopenia, relative lymphocytosis, increased ESR.

Immunological blood tests: RF IgM rarely appears.

Study synovial fluid: color - yellowish-white, viscosity - high, increased number of mononuclear cells, possible isolation of rubella virus.

Arthritis with viral hepatitis B and C

Main diagnostic signs:

arthritis usually appears in the pre-icteric period and disappears at the height of jaundice;

characterized by bilateral symmetrical arthritis with a predominant lesion of the proximal interphalangeal joints, less often - knee, shoulder, hip, elbow, ankle joints;

characterized by the sudden appearance of pain, morning stiffness, soreness and hyperemia of the skin in the area of ​​the affected joints;

clinical recovery is complete;

X-ray examination of the joints does not reveal any pathology.

Laboratory data

Complete blood count: leukopenia, moderate increase in ESR.

Biochemical blood test: increased levels of bilirubin, aminotransferases, organ-specific liver enzymes (fructose-1-phosphate aldolase, ornithine carbamoyltransferase).

Immunological blood tests: markers of hepatitis B and C viruses are detected; RF is rarely detected.

Examination of synovial fluid: increased number of leukocytes.

Arthritis caused by parvovirus B 19

Parvoviruses are small DNA viruses. Joint damage is caused by two parvoviruses: B 19 and RA1. The infection is transmitted by airborne droplets, incubation period- 5-14 days. A characteristic feature The disease is an itchy papular and erythematous rash, localized first on the cheeks, then on the arms and legs (proximal areas), a short dry cough, headache, runny nose.

Arthritis or arthralgia usually appears simultaneously with other symptoms of the disease and is observed in 20% of patients .

Diagnostic features of joint damage in parvovirus infection.

Bilateral symmetrical damage to the small joints of the hands and feet, wrists, elbows and knee joints, characterized by pain, swelling, and stiffness. Joint syndrome lasts about 10 days.

Destructive joint damage usually does not occur.

Fever (in 20% of patients).

The appearance of dark red spots on the mucous membranes.

Prodromal symptoms: headache, myalgia, gastrointestinal disorders, general weakness.

Detection of IgM antibodies to B 19 in the blood serum of patients.

Absent in the blood of the Russian Federation.

Joint damage due to HIV infection

Joint damage due to HIV infection can manifest itself in the following ways:

Acute undifferentiated arthritis

Main manifestations:

acute painful oligoarthritis, mainly of the joints of the lower extremities (knees, ankles);

damage to the tendons of the foot, pain in the Achilles tendon;

The duration of symptoms ranges from a week to several months.

Arthralgia and arthritis

Arthralgia and arthritis (in 30% of patients): pain is localized in the area of ​​2-3 joints (mainly affected large joints lower extremities and shoulders). In the area of ​​the affected joints there is swelling, hyperemia of the skin, and the function of the joints is limited. Damage to the joints can be limited to only very intense pain in the shoulder, elbow, knee, and ankle joints.

HIV-associated Reiter's syndrome

Clinical features:

characterized by pronounced asymmetrical damage to the joints of the lower extremities, such as oligoarthritis;

periarticular changes and tendon lesions are pronounced;

Quite often it happens that joints hurt with HIV. The reason for this phenomenon is considered to be the development of degenerative-dystrophic changes in osteochondral tissue against the background of the aggressive spread of the virus and a decrease in the protective function of the body. Diseases of the musculoskeletal system in HIV infection are observed in more than 50% of patients.

Etiology and pathogenesis of joint pain

Under the influence of HIV infection, the body's protective functions are activated and produce antibodies to the pathogen. Their detail lies in the destruction and disposal of diseased cells connective tissue. Due to severe disturbances in the body, dysfunction occurs immune system. This leads to the fact that antibodies destroy not only pathogenic agents, but also healthy cells own body. Under the influence of a negative factor, all organs and systems suffer, including the musculoskeletal system.

People who are prone to the development of rheumatic syndromes are: HIV carriers, patients with a clear clinical picture of infection, and people with total damage to the immune system (AIDS).

Large joints are mainly affected by immunodeficiency. More often, the patient experiences pain at night, which is associated with impaired blood circulation in the osteochondral tissue. Usually, pain syndrome short-lived and goes away within a few hours without use medicines. With significant degenerative disorders, symptoms subside due to the development of rheumatic syndromes.

Symptoms and course of HIV-associated arthritis

In the initial stages painful sensations in the joints are perceived as manifestations of neuropathy. Only after the appearance of more serious symptoms in the form of swelling and hyperemia of the periarticular skin there is a suspicion of the development of arthritis. The disease is inflammatory in nature and provokes disruption of venous and arterial blood flow inside the joint.

HIV-associated arthritis

A severe form of the disease, which leads to complex internal disorders and obvious visual changes in the structure of the joint. It is a rapidly progressing disease and manifests itself acutely. Mainly affects the joints of the lower and upper limbs with deformation of the phalanges of the fingers. It draws the periarticular tendons into the pathological process. The main symptoms of this type of arthritis are severe pain with increasing intensity and swelling of the soft tissues. With the active development of the disease, there are disruptions in the hydration and nutrition of the skin, which is manifested by dryness and rejection of the upper layers of the epidermis. A severe form of the disease leads to complications in the form of inflammation of the mucous membranes internal organs.

HIV-associated reactive arthritis

The first signs of the disease appear in the first weeks of infection entering the body. In this case, the person does not suspect that he is HIV-infected, but at the same time experiences all the extensive symptoms of arthritis:

• pain syndrome, which is more pronounced after waking up;
• swelling of the joints;
• hyperemia of periarticular tissues;
• inflammatory reaction in other structural units;
• increase lymph nodes due to improper blood flow;
• thickening of the toes.

People infected with the immunodeficiency virus quite often experience pain of various etiologies.

In order to understand why this or that part of the body hurts with HIV, you need to determine the cause of this symptom. According to statistics, almost half of those infected with AIDS discomfort are associated specifically with the disease itself, while for others they are a consequence of treatment or are in no way related to the infection at all. So, what pains with HIV most often bother a patient?

There are psychological (fear of death, inability to enjoy life, heightened sense of guilt) and physical pain. The latter include:

• head;
• localized in the abdomen and chest;
• in the upper gastrointestinal tract: oral cavity, pharynx and larynx;
• joint and muscle.

What muscles hurt with HIV?

If muscles ache with HIV, this indicates tissue damage by the pathogen. This condition occurs in 30% of infections. The most light form- simple myopathy. The most severe is disabling polymyositis. It develops quite early, so it is often considered one of the first signs of the disease. However, even with myopathy, performance is greatly reduced. How do muscles hurt with HIV? Characteristic are aching discomfort that does not get stronger or weaker. It should be noted that back and neck pain cause the most inconvenience to a person. With HIV, this is a normal phenomenon, which, however, greatly interferes with full life. Muscle pain due to HIV can be stopped, but it is necessary to understand that the damaged tissue can hardly be restored. Analgesics have been successfully used for this purpose. The most effective are intramuscular injections.

Joint pain with HIV

Every infected person has wondered at least once: do joints hurt with HIV? The fact is that this kind of manifestation is usually attributed to other ailments. However, it is the most common symptom. Occurs in more than 60% of AIDS patients. Such pains are really very well disguised as rheumatism, which is why anthropopathy itself is often called rheumatic syndrome.

Most often with HIV, large joints hurt, such as:

Such pains are not constant and last no more than a day. They go away on their own, without additional interventions. Occurs due to impaired blood circulation bone tissue. Very often, unpleasant sensations are felt in the evening or at night, much less often during the day.

There are two main signs that will help detect a connection between human immunodeficiency virus infection and joint pain:

• Damage to small joints, e.g. intervertebral discs. This condition is called undifferentiated spondyloarthropathy.
• The presence of several rheumatoid diseases simultaneously in one patient - combined spondyloarthritis.

Both of these indicate a direct relationship between pain and infection. Joint damage can occur as follows:

• Asymmetrical damage to large joints (mainly the lower extremities), accompanied by severe pain, usually associated with necrosis of bone tissue.
• Symmetrical arthritis, which develops quickly and is very similar to rheumatism. Most often it occurs in men and is accompanied by damage to various joints and their groups.

Thus, pain during HIV infection occurs quite often and its intensity varies. Unfortunately, you can only get rid of the symptom for a while, but it is impossible to eliminate the damage itself.

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Diseases of the musculoskeletal system in HIV

Hello!
My legs hurt, they ache, they feel tired, in the knee area, the muscles on the inside of my thighs, my calves. Already in the morning they hurt as if they had been on their feet all day. I don’t know the reason, I’m starting to think about a side effect from the therapy, since for the first time I received such incomprehensible pain in the muscles at the beginning of taking therapy (edurant, tenafovir, abacavir), I had severe diarrhea, for several months, I began to lose weight, and my legs too, and before Until now, my legs have not returned to their previous state, although I have recovered, but my legs are gone. My question is related to therapy, does it affect the pain in my legs? What examinations should I undergo? I noticed that in the center there are a lot of people with walking sticks or walking poorly, is this also due to therapy?

I don’t know what you eat, but I don’t understand you at all. Or am I eating something wrong?)
Ilya, I didn’t start therapy in suspended animation.
And yet, how do you comment treatise from the link above?
And what should I do with the painful muscle, which doctor should I check with and how?
Thanks a lot!

This is a metaphor, it is clear that it is not in suspended animation. However, the meaning is exactly this - immunity in HIV sometimes behaves inappropriately, with or without therapy, just in different directions, and in any of them. For some, autoimmune processes are activated as immunodeficiency increases and are normalized with therapy, for others they fade without therapy and are activated with therapy, and both have their own logic.
Try to find out from a rheumatologist, for example, in any case, rule out something specific.

Belov B.S. Belova O.L. HIV infection: rheumatological aspects, Regular issues of “Breast Cancer” No. 24 dated October 29, 2008 p. 1615. On the topic.

Now everything is clear where the pain in joints and bones comes from. It looks like it's not from tenofovir. The muscle on the back surface hips. My leg has been really hurting and pulling since April, that is, it started hurting even before therapy. How can you test this muscle? Which doctor should I go to? I took the CPK several times - it was normal.
Thank you!

Although, nevertheless, pain in the joints and bones began after taking the therapy.

Although, nevertheless, pain in the joints and bones began after taking the therapy. After the start of therapy, the immune system wakes up, however, with a bunch of arrows in its head and a hole from a shotgun in its chest, and does not always behave adequately.

What kind of pain occurs with HIV infection?

When a person finds out that he is infected with the immunodeficiency virus, premature death is not the worst thing to think about. Pain is a painful consequence of the development of the disease. What hurts with HIV, and is it possible to fight the pain?

What kind of pain can HIV infection cause?

1. Already on early stages As the infection progresses, soreness in the muscles appears (characteristic is aching muscle pain). This is a consequence of damage to muscle tissue. It is observed in 1/3 of all infected people. Primary muscle damage is called myopathy. Movements become constrained and cause discomfort. The extreme degree of tissue damage is polymyositis. A person becomes disabled. He is practically immobilized, the slightest dynamics causes suffering.
2. With HIV infection, changes affect all components of the musculoskeletal system. Patients have pain in the spine, joints, and aching bones. More than half of the carriers complain of such sensations. The virus primarily affects large joints:

• hip;
• shoulder;
• elbows;
• knee

Gradually, stiffness spreads to small joints. Fingers begin to crack. Painful movements are clearly evident in the morning. Then the infected person develops his limbs, and during the day the pain disappears. Typically, this phenomenon disappears as the disease enters a latent stage. This is due to the fact that delivery is disrupted nutrients and oxygen in the tissue of the motor system.

Joint pain itself does not indicate HIV. But if a person experiences several arthritic processes simultaneously, additional research not prevent. A blood test will help determine whether you have a viral load.

A person with retroviral infection complains of neck pain. The reason is often bacterial infections which are manifested by ulcerative lesions of the oral cavity. Local inflammatory processes, accompanying the penetration of HIV into the body, cause enlargement of the lymph nodes in the neck and jaws.

Various viral and bacterial infections attack a person with HIV. This happens due to a drop in the level of T-lymphocytes in the blood. Immunodeficiency viruses infect these cells first. The course of infections is accompanied

• weakness;
• body aches;
• rise in temperature;
• enlarged lymph nodes.

At the pre-AIDS stage, the disease is complemented by opportunistic infections. As the disease progresses, it becomes more and more difficult to fight them. AIDS is characterized by the irreversibility of concomitant diseases. At this stage, the patient’s life is filled with pain of varying intensity and origin. Help to maintain health and avoid dire consequences early diagnosis and timely initiation of therapy.

Sore throat

With HIV, the patient often has a sore throat. Soon after infection, a sore throat may be caused by:

• lesions of the oral mucosa,
• various throat infections.

If the cause of your sore throat is viral infection, it cannot be cured traditional methods. It is necessary to take strong drugs. This feature is characteristic of the presence of HIV in the body. When a patient cannot be cured of a common cold for a long time, his blood is sent for additional tests.

The negative impact of the human immunodeficiency virus on the ENT organs increases over time. At the stage of AIDS, sore throats that occur in severe forms cause a lot of trouble to the patient.

Headaches with HIV

Headaches with HIV at the initial stage accompany common infections.

Reasons that cause severe pain in a later period:

• damage to the central nervous system;
• oncological diseases;
• brain damage due to infections.

To save yourself from suffering from AIDS or delay its approach, a person with a positive HIV status should be attentive to the state of their health. It is recommended to inform your doctor about any changes.

Antiretroviral therapy online

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HIV, ART and joints

Good afternoon, I have been taking Stocrin and Combivir therapy for 5 years, Immune 600, the load is not significant, there have been no side effects, but in the last six months the joints have started to crack a lot, when you raise your arm, the joint of the shoulder, knees, inguinal, wrist crunches, pain has appeared in the back and it radiates V left hand. I asked the doctor at the speed center if there was a connection with taking therapy, to which he shrugged it off and said that it was mine, although I don’t think that everything can’t start to crunch so suddenly, I did an MRI thoracic cervical spine There is no osteochondrosis, they said neither of them, I did an ECG, not theirs either.
But the pain in the back with crunching remained the same, this crunching can be heard from a distance. I drank Teraflex Nise, injected Milgama intramuscularly, to no avail. Milgama makes the pain go away for a while, but only for a while, so I think what it is and how to deal with it. I noticed that the pain begins to intensify when I freeze a little, but the crunching is constant. I would be grateful for your advice.

Hello, please help! VN is not determined, IS 650, on therapy. Arthritis since childhood, I take NSAIDs, but despite this my knee ached and swollen and the rheumatologist (doesn’t know about HIV) prescribed a physio-ultrasound with hydrocortisone. Can hydrocortisone affect IS?

Depends on dose and exposure. On average – no or not significant.

I am immensely grateful to you

Ilya, thank you. I was also prescribed the drug Ambene for 5 days, they haven’t sold it in Russia for a couple of years, I ordered it, I need to start, I’m afraid because of the hormone, I’m worried, please tell me, will the IP not drop significantly? Thank you

Ekaterina, Ilya, good evening! I received a knee injury on both legs, a grade 2 sprain and a linear tear in the posterior medial horn of the meniscus on one leg. We are trying to treat it conservatively, due to wearing artesis and bandages for a long time, muscle atrophy began, the doctors prescribed exercise therapy in the complex to pump up the muscles, and offer injections platelet-rich plasma into the joint, please tell me, is there any risk with HIV, is it dangerous? I didn’t tell the doctors about the illness. Thank you

Good day, please tell me, I found out about the status in March, I was admitted to the hospital with CD4-5, at the moment the cells have risen to 102 VN, undetectable, but problems with my leg started) at first I thought sciatic nerve, mri. X-ray, osteoscan shows inflammation of the bone, a lesion in the hip bone, the orthopedist sent me to a neurosurgeon, he sends me to a traumatologist, in general, they hear that it’s HIV and no one wants to do anything: I haven’t walked for a month, I walk on a stick. Does anyone know what to do, what antibiotics and what it could be? On art 6 months of Kivex + efavirens

Ideally, a biopsy and a good histologist, if possible, a culture. Having understood, decide.

Thank you, Ilya. There are no other complaints, no pain, and I really hope there won’t be any. But it’s better to get it checked, at least to monitor the dynamics.
And what does it mean “how effective are the doses” (he is not taking D3 yet, it’s better to get tested first, I don’t want to treat something at random, it’s not clear what, it’s not clear with what).

The point is that sometimes the same 5000 IU per day can be excessive, which is not harmful, but only excessive. Therefore, you can increase, say, up to 15-20 thousand IU per week, for example, taking PT-Sat-Sun only.

Hello.
My husband has been taking the regimen of tenovofir, lamivudine, efavirenz for a year now, there are no complaints about side effects, VN but, IS 255, the dynamics are positive. And I don’t want to jump from diagram to diagram without real evidence. But I began to notice a crunch in the knees and ankles when he squatted. In general, I want to examine him on this issue. Where to begin? What tests need to be taken, what indicators should I pay attention to? As I understand it, definitely do densitometry, plus check calcium and D3? Is that all, or is there something else? I’ve read a lot about inflammation markers, but I didn’t understand much. In general, what to do with the crunch? He won’t go to the therapist or rheumatologist at the clinic because he doesn’t trust him. Apparently we’ll go to private clinics at our own expense, so we don’t want to donate too much, so please tell me what tests and in what sequence we really need to take.

As I understand it, definitely do densitometry, plus check calcium and D3? The first and third – it is advisable to have them at least once every few years, as guidelines. The first is to compare it later, in five years, 25(OH)D3 - to understand how effective the doses for D3 are, you don’t have to look at the basic one, there is no D3 yet. Just a crunch is not a reason to fuss if there are no other complaints

Good evening everyone)) I’m new to your forum, I’ve known about the status since the end of April last year and since May 2016 I’ve already been on therapy (Aluvia and tenofovir). By chance I came across this particular discussion, the topic is exactly mine, a sore one; Since the fall of last year, I have been tormented by various uncomfortable sensations in my legs, from the knee to the foot, that is, the lower part: sometimes numbness, sometimes like a heaviness, sometimes like a lingering pain, sometimes it comes on its own and then goes away; last year I took tests for rheuma - everything was fine according to the tests, I checked the veins/vessels, my doctor from the SC didn’t say anything like that, as I read on your forum, about such side effects, although I complained to her about this more than once; They also suggested that a nerve might be pinched in the pelvic region due to the fact that I was lifting a child in my arms and was forbidden to do this, but now for about two weeks this issue has been bothering me, although I don’t carry heavy weights, I don’t drink, my lifestyle is adequate, tell me what to do? Since it really brings a lot of discomfort, is 735 somewhere like this; thank you very much in advance for your answer!)

There is a high probability of problems in lumbar region spine, maybe somewhere further along the nerves. A good vertebroneurologist will find and show where and what.

Doctor,
I just noticed that in your first answer I missed - “there were at least some suspicions towards the individual entrepreneur.”
it was a question? and what is IP?

Yes, I understand, not just everything...
I realized that the process has begun with my hip joints, and now I need to prepare for prosthetics.
Doctor, please, I have a question for you:
- does this mean that now gradually the same thing will happen to all my other joints?
— if so, is it possible to stop or slow down this process?
..or should I accept that this is the case now?!
Thanks in advance for your answer!

No, that doesn't mean it. And you can butt heads with these too.
Yes, it’s possible, but these questions are not for me, but for a specialized specialist. The situation should be considered outside the context of HIV.

only if a specialized specialist finds out about HIV and therapy, then he sends you to doctors at the SC, and the doctors at the SC say - we don’t know why you are looking for another specialized specialist. Vicious circle.

Thank you Doctor!
So, I will fight!)

Good evening! Please help me figure it out!
At the end of the 2000s he received a residence permit in Malta.
In 2015, I learned about my HIV+ status and registered with a local health center.
In February 2016, he began therapy - Kivexa + Isentress.
Now my CD4 is 1136, Vir.L is not detectable.
Three months ago I began to experience periodic sharp pain in the back
thighs of the left leg. I didn’t pay any attention to it because I thought it was related to the gym.
But gradually the pain became more and more frequent
Once again I read the instructions for both medications, which indicate that there is a possibility of Osteronecrosis.
Now I'm in Moscow for work. Yesterday I had an MRI -
“There is insufficient head coverage femur by 1/3.
In the area of ​​the edges of the articular surfaces of the femoral heads and acetabulums,
bone growths. Chondromalacia of the articular cartilage of the femoral heads is determined
and acetabulum of 2-3 degrees, joint spaces are narrowed. In the cavity of the joints it is determined
physiological amount of fluid. Soft fabrics without features, no enlarged lymph nodes were detected at the research level.
Conclusion: bilateral dysplastic osteoarthritis hip joint 2 tbsp."
I called my doctor. the doctor and told everything.
He was sincerely surprised and said that this was their first such case.
He said that if I wanted, I could go there and ask to change the therapy.
The SC there is wonderful, there good people, but one problem is the small population
and apparently very little experience. I see that doctors are ready to help, but it seems that this is the first time they themselves have encountered this.
Having read a lot of different things, I no longer understand what to do, I’m completely confused.
I would like to ask you, please advise
I still have to be in Moscow for a month for work. But if you can’t waste so much time and need something
change it urgently, I can leave.
Main question: Should I change therapy or not? If you don’t change it, then what to do with the problem in the hip joint that is progressing?!
And if you change therapy, which one, what options might there be?
My condition is definitely getting worse, the pain is getting worse, and it’s getting more and more difficult to move my leg.
Please advise what to do?!

Joint pain with HIV

Quite often it happens that joints hurt with HIV. The reason for this phenomenon is considered to be the development of degenerative-dystrophic changes in osteochondral tissue against the background of the aggressive spread of the virus and a decrease in the protective function of the body. Diseases of the musculoskeletal system in HIV infection are observed in more than 50% of patients.

Etiology and pathogenesis of joint pain

Under the influence of HIV infection, the body's protective functions are activated and produce antibodies to the pathogen. Their detail lies in the destruction and disposal of diseased connective tissue cells. Due to severe disturbances in the body, dysfunction of the immune system occurs. This leads to the fact that antibodies destroy not only pathogenic agents, but also healthy cells of their own body. Under the influence of a negative factor, all organs and systems suffer, including the musculoskeletal system.

People who are prone to the development of rheumatic syndromes are: HIV carriers, patients with a clear clinical picture of infection, and people with total damage to the immune system (AIDS).

Large joints are mainly affected by immunodeficiency. More often, the patient experiences pain at night, which is associated with impaired blood circulation in the osteochondral tissue. As a rule, the pain syndrome is short-lived and goes away after a few hours without the use of medications. With significant degenerative disorders, symptoms subside due to the development of rheumatic syndromes.

Symptoms and course of HIV-associated arthritis

At the initial stages, pain in the joints is perceived as manifestations of neuropathy. Only after the appearance of more serious symptoms in the form of swelling and hyperemia of the periarticular skin does a suspicion arise about the development of arthritis. The disease is inflammatory in nature and provokes disruption of venous and arterial blood flow inside the joint.

HIV-associated arthritis

A severe form of the disease, which leads to complex internal disorders and obvious visual changes in the structure of the joint. It is a rapidly progressing disease and manifests itself acutely. It mainly affects the joints of the lower and upper extremities with deformation of the phalanges of the fingers. It draws the periarticular tendons into the pathological process. The main symptoms of this type of arthritis are severe pain with increasing intensity and swelling of the soft tissues. With the active development of the disease, there are disruptions in the hydration and nutrition of the skin, which is manifested by dryness and rejection of the upper layers of the epidermis. A severe form of the disease leads to complications in the form of inflammation of the mucous membranes of internal organs.

HIV-associated reactive arthritis

The first signs of the disease appear in the first weeks of infection entering the body. In this case, the person does not suspect that he is HIV-infected, but at the same time experiences all the extensive symptoms of arthritis:

In reactive arthritis, the lymph nodes become enlarged.

• pain syndrome, which is more pronounced after waking up;
• swelling of the joints;
• hyperemia of periarticular tissues;
• inflammatory reaction in other structural units;
• enlarged lymph nodes due to improper blood flow;
• thickening of the toes.