Human Immunodeficiency Virus And Total Joint Arthroplasty: The Risk For Infection Is Reduced

Abstract Background Highly-active antiretroviral therapy (HAART) has changed the face of human immunodeficiency virus (HIV) and allowed patients to live for many decades. HIV and HAART are known risk factors for osteonecrosis of bone, osteopenia, and osteoporosis. Therefore, the demand for total joi...

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Published in:The Journal of arthroplasty 2016-10, Vol.31 (10), p.2146-2151
Main Authors: Enayatollahi, Mohammad Ali, MD, Murphy, Dermot, Maltenfort, Mitchell G., PhD, Parvizi, Javad, MD FRCS
Format: Article
Language:English
Subjects:
Antiretroviral Therapy, Highly Active
Arthritis, Infectious - etiology
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Knee - adverse effects
hemophilia
Hemophilia A - complications
highly active antiretroviral therapy
HIV Infections - complications
HIV Infections - drug therapy
human immunodeficiency virus
Humans
Odds Ratio
Orthopedics
periprosthetic joint infection
Prosthesis-Related Infections - etiology
Prosthesis-Related Infections - prevention & control
Risk Factors
total joint arthroplasty
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Summary:Abstract Background Highly-active antiretroviral therapy (HAART) has changed the face of human immunodeficiency virus (HIV) and allowed patients to live for many decades. HIV and HAART are known risk factors for osteonecrosis of bone, osteopenia, and osteoporosis. Therefore, the demand for total joint arthroplasty (TJA) in HIV-infected patients is on the rise. We attempted to determine whether modern treatments for HIV have impacted the rate of periprosthetic joint infection (PJI). Materials and Methods Conducting a systematic review, 25 studies with a total of 722 TJAs were identified. We extracted data on rates of PJI after primary TJA in HIV-infected patients with and without hemophilia and data on administration of HAART at the time of arthroplasty. Results Three hundred eighty-one TJAs were performed in 293 patients with HIV infection without hemophilia. The follow-up ranged between 1.5 months and 11 years. Nine patients developed PJI. In patients with both HIV and hemophilia, 341 primary TJA were performed. Forty-five received treatment for PJI. Follow-up ranged beween one year and 26 years. Rates of PJI were 2.28% and 10.98% for HIV-only patients and patients with HIV and hemophilia, respectively. This difference was statistically significant (p
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2016.02.058