Infect Chemother.  2012 Dec;44(6):508-511. 10.3947/ic.2012.44.6.508.

Avascular Necrosis of Femoral Head in HIV-infected Patients: Case Reports and Review of the Literature

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. molder@unitel.co.kr

Abstract

After introduction of highly active antiretroviral therapy, the incidence of opportunistic infections and malignancies in HIV patients decreased. On the other hand, several osteoarticular complications are increasingly reported. Avascular necrosis of femoral head is one of such complications. HIV-infected patients have an 100-fold increased risk of avascular necrosis of femoral head compared to the general population. Many risk factors for this debilitating complication have been suggested. This paper reports five cases of avascular necrosis of femoral head in HIV-infected patients with review of literature.

Keyword

Osteonecrosis; Femur; Human immunodeficiency virus

MeSH Terms

Antiretroviral Therapy, Highly Active
Femur
Hand
Head
HIV
Humans
Incidence
Necrosis
Opportunistic Infections
Osteonecrosis
Risk Factors

Figure

  • Figure 1 (A) Pelvis plain X-ray showed osteonecrosis of bilateral femoral heads and necks with collapse (B) T1 weighted magnetic resonance (MR) images show the necrosis and collapse of the bilateral femoral heads.


Reference

1. Goorney BP, Lacey H, Thurairajasingam S, Brown JD. Avascular necrosis of the hip in a man with HIV infection. Genitourin Med. 1990. 66:451–452.
Article
2. Keruly JC, Chaisson RE, Moore RD. Increasing incidence of avascular necrosis of the hip in HIV-infected patients. J Acquir Immune Defic Syndr. 2001. 28:101–102.
Article
3. Hasse B, Ledergerber B, Egger M, Flepp M, Bachmann S, Bernasconi E, Egger M, Guyot S, Hirschel B, Weber R, Günthard HF. Swiss HIV Cohort Study. Antiretroviral treatment and osteonecrosis in patients of the Swiss HIV Cohort Study: a nested case-control study. AIDS Res Hum Retroviruses. 2004. 20:909–915.
Article
4. Miller KD, Masur H, Jones EC, Joe GO, Rick ME, Kelly GG, Mican JM, Liu S, Gerber LH, Blackwelder WC, Falloon J, Davey RT, Polis MA, Walker RE, Lane HC, Kovacs JA. High prevalence of osteonecrosis of the femoral head in HIV-infected adults. Ann Intern Med. 2002. 137:17–25.
Article
5. Park KS, Diwanji SR, Park SJ, Cho SG, Yim JH, Yoon TR. Avascular necrosis of femoral head treated by total hip replacement in AIDS patients: a case report. J Korean Hip Soc. 2007. 19:508–512.
Article
6. Allison GT, Bostrom MP, Glesby MJ. Osteonecrosis in HIV disease: epidemiology, etiologies, and clinical management. AIDS. 2003. 17:1–9.
7. Molia AC, Strady C, Rouger C, Beguinot IM, Berger JL, Trenque TC. Osteonecrosis in six HIV-infected patients receiving highly active antiretroviral therapy. Ann Pharmacother. 2004. 38:2050–2054.
Article
8. Koller E, Mann M, Malozowski S, Bacsanyi J, Gibert C. Aseptic necrosis in HIV seropositive patients: a possible etiologic role for megestrol acetate. AIDS Patient Care STDS. 2000. 14:405–410.
Article
9. Calza L, Manfredi R, Mastroianni A, Chiodo F. Osteonecrosis and highly active antiretroviral therapy during HIV infection: report of a series and literature review. AIDS Patient Care STDS. 2001. 15:385–389.
Article
10. Glesby MJ, Hoover DR, Vaamonde CM. Osteonecrosis in patients infected with human immunodeficiency virus: a case-control study. J Infect Dis. 2001. 184:519–523.
Article
11. Mary-Krause M, Billaud E, Poizot-Martin I, Simon A, Dhiver C, Dupont C, Salmon D, Roudiere L, Costagliola D. Clinical Epidemiology Group of the French Hospital Database. Risk factors for osteonecrosis in HIV-infected patients: impact of treatment with combination antiretroviral therapy. AIDS. 2006. 20:1627–1635.
Article
12. Sighinolfi L, Carradori S, Ghinelli F. Avascular necrosis of the femoral head: a side effect of highly active antiretroviral therapy (HAART) in HIV patients? Infection. 2000. 28:254–255.
Article
13. Lee MJ, Corrigan J, Stack JP, Ennis JT. A comparison of modern imaging modalities in osteonecrosis of the femoral head. Clin Radiol. 1990. 42:427–432.
Article
14. Van den Wyngaert T, Huizing MT, Vermorken JB. Osteonecrosis of the jaw related to the use of bisphosphonates. Curr Opin Oncol. 2007. 19:315–322.
Article
15. Hernigou P, Poignard A, Nogier A, Manicom O. Fate of very small asymptomatic stage-I osteonecrotic lesions of the hip. J Bone Joint Surg Am. 2004. 86:2589–2593.
Article
16. Morse CG, Mican JM, Jones EC, Joe GO, Rick ME, Formentini E, Kovacs JA. The incidence and natural history of osteonecrosis in HIV-infected adults. Clin Infect Dis. 2007. 44:739–748.
Article
Full Text Links
  • IC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr