Arthritis in the acquired immunodeficiency syndrome and other viral infections.

Musculoskeletal conditions occurring in individuals with human immunodeficiency virus infection are becoming increasingly well documented. Arthritis with features of Reiter's syndrome or psoriatic arthritis has been further studied; an association with HLA-B27 but not with HLA antigens chemically associated with psoriasis or psoriatic arthritis has been demonstrated. Human immunodeficiency virus has been identified in synovial fluid dendritic cells and in the synovium; immunohistochemical analysis is revealing the nature of the lymphocyte infiltrate in the synovium of affected individuals. Postmortem studies suggest that there may be histologic evidence of premature aging in clinically unaffected joints from patients with acquired immunodeficiency syndrome. Epidemiologic studies are needed to elucidate which rheumatic lesions occur as a direct consequence of human immunodeficiency infection and which may be chance associations.