Abstract
Background: The aim of the study is to determine the prevalence of HIV infection among adult patients with reactivation of haematogenous chronic osteomyelitis. Methods: A retrospective analysis of prospectively collected data from 143 adult patients with chronic osteomyelitis. Results: A total of 143 patients were included in the study group, with a mean age of 38 years (range 14–78 years). Twenty-two per cent (n=31) of patients were diagnosed with reactivation of chronic haematogenous osteomyelitis, while 78% of patients had contiguous chronic osteomyelitis (29% [n=42] post-operative and 49% [n=70] post-traumatic, respectively). Forty (28%) patients were found to be HIV positive with a mean CD4 count of 414 cells/mm³ (range 13–1 034 cells/mm³). Twenty-four (60%) of patients with HIV were on antiretroviral therapy at time of diagnosis. The prevalence of HIV infection among patients with contiguous (post-operative or post-traumatic) infections was 32%, in comparison to 13% in the group with reactivation of chronic haematogenous infections (p=0.04; OR 3.2; 95% CI 1.0–9.8). Conclusion: The prevalence of HIV infection among patients with reactivation of chronic haematogenous osteomyelitis appeared to be lower than that seen in patients with chronic osteomyelitis from other causes and lower than that seen in the general population in South Africa. Level of evidence: Level 4
Highlights
The total number of people living with human immunodeficiency virus (HIV) in South Africa is currently estimated at approximately 7.06 million
Following ethical approval from the relevant biomedical ethics review board, data were collected with respect to patient age, cause of osteomyelitis, physiological host stage and anatomic nature of the disease according to the Cierny and Mader classification system, HIV status, CD4 count and the presence of antiretroviral therapy
Twenty-two per cent (n=31) of patients were diagnosed with reactivation of chronic haematogenous osteomyelitis, while 78% of patients had contiguous chronic osteomyelitis (29% [n=42] post-operative and 49% [n=70] post-traumatic, respectively)
Summary
The total number of people living with human immunodeficiency virus (HIV) in South Africa is currently estimated at approximately 7.06 million. The prevalence in KwaZulu-Natal, the second largest province in South Africa with a population of approximately 11.1 million people, is currently estimated at 21.5%.2. The aim of the study is to determine the prevalence of HIV infection among adult patients with reactivation of haematogenous chronic osteomyelitis. The prevalence of HIV infection among patients with contiguous (post-operative or post-traumatic) infections was 32%, in comparison to 13% in the group with reactivation of chronic haematogenous infections (p=0.04; OR 3.2; 95% CI 1.0–9.8).
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