Vasculitides in HIV Infection
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VASCULITIS (L ESPINOZA, SECTION EDITOR)
Vasculitides in HIV Infection Luis E. Vega 1 & Luis R. Espinoza 2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review To review the spectrum of vasculitides in HIV-infected patients and to identify the clinical features that characterize vasculitis in sero-positive HIV. Recent Findings Epidemiological studies conducted in the post-HAART era described the rarity of vasculitis in the setting of HIV-infected patients. A study identified histopathological features such as leukocytoclastic vasculitis of the vasa vasorum and adventitial inflammation in the large artery pathology of HIV-positive patients compared with HIV-negative patients with critical lower limb ischemia. A recent retrospective cohort study reported that HIV-positive patients with LVV developed more vascular complications, responded less to antiretroviral therapy, and had worse outcome than HIV-negative patients with LVV. Summary Vasculitides continue to be a rare disease in patients with HIV. The spectrum of vasculitis ranges from life-threatening conditions to relatively mild skin conditions. Recognizing vasculitis in the setting of HIV-positive patients is important because sometimes it require immunosuppressive treatment. Keywords HIV infection . Vasculitides . Polyarteritis nodosa . Kawasaki-like syndrome . Large-vessel vasculitis
Introduction At the time of writing, the world grapples with the pandemic of COVID-19, each day passing continues to increase the number of lives lost and the human suffering. Nearly 40 years have elapsed since the occurrence of HIV pandemic which caused high mortality among affected population [1]. An analogous situation such as stigmas, diagnostic testing, and treatment almost similar to the beginning of the HIV pandemic is the one we are seeing in this new global medical emergency due to the pandemic caused by infection with SARS-CoV-2 coronavirus (COVID-19) [2]. The immunodeficiency status of patients with HIV/AIDS was accompanied by the occurrence of inflammatory and autoimmune diseases and is an
This article is part of the Topical Collection on Vasculitis * Luis E. Vega [email protected] 1
Section of Rheumatology, Air Force Central Hospital, Aramburú Ave 2nd block, Lima, Peru
2
Louisiana State University Health Sciences Center, 433 Bolivar St, New Orleans, LA 70112, USA
issue that needs to be kept in mind and that their development still is an enigma.
Epidemiology Reliable studies on the prevalence of HIV-associated vasculitis are scarce because there are few high-quality, descriptive, longitudinal, and cohort studies. There are prevalence data from studies that have been conducted in hospitals, but this is not a true representation of what occurs in the general population. Vasculitis has been uncommonly associated with HIV infection, and the literature have reported a frequency < 1% [3]. Contrary to these data, Zhang et al. in a study conducted in Asian patients infected with HIV/AIDS showed higher prevalence of vasculi
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