HIV in Children
November 2014 NEWSLETTER


HIV IN CHILDREN
November 2014 Newsletter
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GRAND ROUNDS
A 9 years old girl presented with fever, bodyache, pain in abdomen and multiple joint pains and joint swelling for 3 days. She was diagnosed to be HIV infected 2½ years ago.
On examination, she was malnourished, had pallor and bilateral ankle and right wrist swelling which were tender and there were restriction of movements. On systemic examination, she had crepitations in right infra axillary region. Other examination findings were normal.
Investigations showed:
• RA factor, ANA, ds DNA – Negative
• CD4 count = 324, CD4 percent = 12.3%, CD4 : CD8 = 0.26

She was treated with anti-inflammatory drugs and antibiotics to which her fever and pneumonia responded but joint pain persisted. She was subsequently started on Antiretroviral therapy (ART) consisting of Zidovudine (AZT), Lamivudine (3TC) and Efavirenz (EFV). After one week of ART, the ankle joints and wrist joint were normal, but now she had left knee joint involvement.

What is the cause of her joint involvement?

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