The effect of concomitant fibromyalgia in HIV infected patients receiving antiretroviral therapy: a prospective cross-sectional study, 2019, Demirdal

[Andy]

Background
HIV infected patients receiving antiretroviral therapy (ART) have extensive musculoskeletal system involvement. Arthralgia and myalgia are the most common forms. Fibromyalgia Syndrome (FMS) is a chronic pain syndrome of the musculoskeletal system characterized by diffuse pain including arthralgia and myalgia. These overlapping symptoms are suggested the relationship between HIV and FMS. The primary purpose of this study was to determine the prevalence of FMS in HIV/AIDS patients. The secondary objective was to investigate the effects of FMS on functional status, depression, fatigue, sleep pattern and quality of life.

Methods
A total of 225 HIV infected patients who were receiving ART were included in this cross-sectional prospective study. The demographic data of the participants, CD4 T-lymphocyte count (cells/mm3), viral load (> 40 copy/ml), and ART regimens were recorded. FMS diagnosis was based on 2016 revision of diagnostic criteria. All patients completed the following questionnaires: Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), and SF-36 scale.

Results
FMS was found in 20% of the HIV infected patients (n = 45). The mean duration of disease was 4.74 ± 4.42 years; it was significantly longer in patients with FMS (p = 0.007). The median CD4 T-lymphocyte count was found to be 616.00 ± 303.91 cells/mm3, and it was significantly higher in patients without FMS (p = 0.06). No statistically significant difference was found between the two groups according to the drug regimens used. A statistically significant difference was found in FIQ, BDI, PSQI, FSS and all subgroups of the SF-36 scale between the patients with and without FMS (p = 0.001).

Conclusions
A slightly higher frequency of FMS was determined in HIV infected patients receiving ART compared to previous studies. It was shown that presence of FMS negatively affected the function, depression, fatigue, sleep, and quality of life. Detection of FMS may decrease depression, fatigue, and sleep disorders and increase the quality of life in HIV infected patients. FMS should be distinguished correctly for an accurate treatment management of HIV and for increasing ART compliance.

Open access, https://ann-clinmicrob.biomedcentral.com/articles/10.1186/s12941-019-0330-0

 

[rvallee]

FMS was found in 20% of the HIV infected patients

Abnormally high. Suggesting either poor diagnosis or that the aforementioned widespread pain found in HIV patients is similar to FM, to a degree anyway.

Detection of FMS may decrease depression, fatigue, and sleep disorders and increase the quality of life in HIV infected patients

Right idea, but detection doesn't mean diddly-squat without useful treatments. Proper treatment would to those things, not mere detection.

The median CD4 T-lymphocyte count was found to be 616.00 ± 303.91 cells/mm3, and it was significantly higher in patients without FMS (p = 0.06)

This seems to be the interesting bit. Though that's a big spread:

FM: 501.57 ± 309.0, No FM: 642.70 ± 297.3

Only tables, doesn't appear to be figures.

That was interesting too:

In HIV/AIDS patients, fatigue was associated with depression

More likely that it reveals that typical questionnaires used for fatigue assessment make little distinction between what is actually experienced and reported by patients with what researchers have redefined fatigue to mean, i.e. something entirely different based on some perception of tiredness. Typical.

Given how specific antiretroviral therapy is, not much of a surprise that it doesn't have any effect. FM could be similarly caused by immune response to infection, but it's unlikely to be caused by a specific virus, let alone a retrovirus. Still, some interesting things out of this study.