Increased prevalence and severity of radiographic hand osteoarthritis in patients with HIV-1 infection associated with metabolic syndrome: data from the cross-sectional METAFIB-OA study

Anne-Laurence Tomi (1, 1) , Jérémie Sellam (2, 1, 1) , Karine Lacombe (3) , Soraya Fellahi (4, 5, 1, 2) , Manuela Sebire (1) , Caroline Rey-Jouvin (1) , Anne Miquel (1) , Jean-Philippe Bastard (1, 4, 5) , Emmanuel Maheu (1, 1) , Ida K Haugen (6) , David T Felson (7) , Jacqueline Capeau (1, 2, 4, 5) , Pierre-Marie Girard (3, 1) , Francis Berenbaum (1, 1, 2) , Jean-Luc Meynard (1)

1 CHU Saint-Antoine [AP-HP]
2 UMRS893 - Centre de Recherche Saint-Antoine
3 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
4 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
5 CHU Tenon [AP-HP]
6 Department of Rheumatology [Oslo]
7 Tufts University School of Medicine [Boston]

Objective: To determine radiographic hand osteoarthritis (HOA) prevalence in patients with HIV-1 infection in comparison with the general population and to address whether metabolic syndrome (MetS) may increase the risk of HOA during HIV-1 infection. Patients: Patients with HIV-1 infection and MetS (International Diabetes Federation, IDF criteria) aged 45–65 years were matched by age and gender to HIV-1-infected subjects without MetS and underwent hand radiographs. Framingham OA cohort was used as general population cohort. Methods: Radiographic HOA was defined as Kellgren–Lawrence (KL) score ≥2 on more than one joint. Radiographic severity was assessed by global KL score and number of OA joints. HOA prevalence was compared with that found in the Framingham study, stratified by age and sex. Logistic and linear regression models were used to determine the risk factors of HOA in patients with HIV-1 infection. Results: 301 patients (88% male, mean age 53.4±5.0 years) were included, 152 with MetS and 149 without it. Overall, HOA prevalence was 55.5% and was higher for those with MetS than those without it (64.5% vs 46.3%, p=0.002). When considering men within each age group, HOA frequency was greater in patients with HIV-1 infection than the general population (all ages: 55.8% vs 38.7%; p<0.0001), due to the subgroup with MetS (64.9%; p<0.0001), as well as the subgroup without MetS, although not significant (46.6%; p=0.09). Risk of HOA was increased with MetS (OR 2.23, 95% 95% CI 1.26% to 3.96%) and age (OR 1.18, 95% CI 1.12 to 1.25). HOA severity was greater for patients with MetS than those without. HOA was not associated with previous or current exposure to protease inhibitors or HIV infection-related markers. Conclusions: HOA frequency is greater in patients with HIV-1 infection, especially those with MetS, than the general population.

Mots clés: osteoarthritis; HIV-1; hand; aging; metabolic syndrome; metabolic osteoarthritis

Domaines: Rhumatologie et système ostéo-articulaire; Maladies infectieuses; Santé publique et épidémiologie

Anne-Laurence Tomi, Jérémie Sellam, Karine Lacombe, Soraya Fellahi, Manuela Sebire, et al.. Increased prevalence and severity of radiographic hand osteoarthritis in patients with HIV-1 infection associated with metabolic syndrome: data from the cross-sectional METAFIB-OA study. Annals of the Rheumatic Diseases, 2016, 75 (12), pp.2101-2107. ⟨10.1136/annrheumdis-2016-209262⟩. ⟨hal-01534146⟩