Epiphyseal Necrosis in Patients with HIV Infection and Free from Sickle Cell Disease

Abstract

We report a series of 17 cases of epiphyseal necrosis observed in nine women aged 40 years on average. These nine patients, with HIV1 infection, were free from other risk factors of bone necrosis, especially SS and sickle cell disease. The necrosis affected the two femoral heads in 6 patients, one femoral head in one patient, one humeral head in one patient, and the two femoral heads and one humeral head in the last patient. The necrosis revealed HIV1 infection in 4 patients. It has complicated the course of HIV1 infection in other 5 patients, despite antiretroviral therapy. These observations argue in favor of the etiological role of HIV infection in the occurrence of epiphyseal necrosis. The relatively young age of the patients and the high number of bilateral involvement testify to the severity of the necrosis induced by HIV.