Is treated HIV infection associated with knee cartilage degeneration and structural changes? A longitudinal study using data from the osteoarthritis initiative

Metabolic disorders presenting in HIV-infected patients on antiretroviral therapy (ART) may increase the risk of osteoarthritis. However, structural changes of the knee in HIV infected subjects are understudied. The aim of this study is to investigate knee cartilage degeneration and knee structural...

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Bibliographic Details
Published in:	BMC musculoskeletal disorders 2019-05, Vol.20 (1), p.190-190, Article 190
Main Authors:	Liu, Yao, Foreman, Sarah C, Joseph, Gabby B, Neumann, Jan, Tien, Phyllis C, Li, Xiaoming, Lane, Nancy E, Nevitt, Michael C, McCulloch, Charles E, Link, Thomas M
Format:	Article
Language:	eng
Subjects:	Acquired immune deficiency syndrome Adipose Tissue - diagnostic imaging Adipose Tissue - pathology AIDS Anti-HIV Agents - adverse effects Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Arthritis Body mass index Bone marrow Care and treatment Cartilage Cartilage diseases Cartilage, Articular - diagnostic imaging Cartilage, Articular - pathology Case-Control Studies Cross-Sectional Studies Cysts Degeneration Development and progression Diagnostic imaging Disease Progression Edema Effusion Entropy Female Health aspects Highly active antiretroviral therapy HIV HIV infections HIV Infections - complications HIV Infections - drug therapy HIV Infections - immunology HIV Infections - metabolism HIV patients Human immunodeficiency virus Humans Knee Knee Joint - diagnostic imaging Knee Joint - pathology Ligaments Longitudinal Studies Magnetic Resonance Imaging Male Meniscus Metabolic disorders Middle Aged Osteoarthritis Osteoarthritis, Knee - diagnostic imaging Osteoarthritis, Knee - epidemiology Osteoarthritis, Knee - etiology Osteoarthritis, Knee - pathology Regression analysis Risk Factors Synovitis Synovitis - diagnostic imaging Synovitis - epidemiology Synovitis - etiology Synovitis - pathology
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Summary:	Metabolic disorders presenting in HIV-infected patients on antiretroviral therapy (ART) may increase the risk of osteoarthritis. However, structural changes of the knee in HIV infected subjects are understudied. The aim of this study is to investigate knee cartilage degeneration and knee structural changes over 8 years in subjects with and without HIV infection determined based on the use of ART. We studied 10 participants from the Osteoarthritis Initiative who received ART at baseline and 20 controls without ART, frequency matched for age, sex, race, baseline body mass index (BMI) and Kellgren & Lawrence grade. Knee abnormalities were assessed using the whole-organ magnetic resonance imaging score (WORMS) and cartilage T2 including laminar and texture analyses were analyzed using a multislice-multiecho spin-echo sequence. Signal abnormalities of the infrapatellar fat pad (IPFP) and suprapatellar fat pad (SPFP) were assessed separately using a semi-quantitative scoring system. Linear regression models were used in the cross-sectional analysis to compare the differences between ART/HIV subjects and controls in T2 (regular and laminar T2 values, texture parameters) and morphologic parameters (subscores of WORMS, scores for signal alterations of IPFP and SPFP). Mixed effects models were used in the longitudinal analysis to compare the rate of change in T2 and morphological parameters between groups over 8 years. At baseline, individuals on ART had significantly greater size of IPFP signal abnormalities (P = 0.008), higher signal intensities of SPFP (P = 0.015), higher effusion scores (P = 0.009), and lower subchondral cysts sum scores (P = 0.003) compared to the controls. No significant differences were found between the groups in T2-based cartilage parameters and WORMS scores for cartilage, meniscus, bone marrow edema patterns and ligaments (P > 0.05). Longitudinally, the HIV cohort had significantly higher global knee T2 entropy values (P = 0.047), more severe effusion (P = 0.001) but less severe subchondral cysts (P = 0.002) on average over 8 years. Knees of individuals with HIV on ART had a more heterogeneous cartilage matrix, more severe synovitis and abnormalities of the IPFP and SPFP, which may increase the risk of incident knee osteoarthritis.
ISSN:	1471-2474 1471-2474