Avascular necrosis in five patients with human immunodeficiency virus (HIV) infection

Abstract

Avascular necrosis (AVN) of bone occurring in patients infected with Human Immunodeficiency Virus (HIV) has been well documented in recent literature. Contributing factors may include drug treatment (steroids and protease inhibitors), hyperlipidaemia, hyperviscosity, antiphospholipid antibodies, or the virus itself. We have retrospectively reviewed case notes of all patients seen in our department with AVN (n=5). We conclude that although steroids play an important role, the aetiology of AVN in HIV is multifactoral. The orthopaedic surgeon should consider AVN in the differential diagnosis of patients with HIV infection presenting with painful joints.