Document Detail

Avascular osteonecrosis of the femoral head in three West African HIV-infected adults with heterozygous sickle cell disease.
MedLine Citation:
PMID:  19918106     Owner:  NLM     Status:  MEDLINE    
Three men (aged 33, 44 and 45 years, CD4(+) T-cell nadir 86 cells/mm(3), 99 cells/mm(3) and 12 cells/mm(3), respectively) were admitted to the Department of Infectious Diseases (Treichville Hospital, Abidjan, C??te d'Ivoire) for hip pain and impaired mobility. Their last available CD4(+) T-cell counts were 243 cells/mm(3), 245 cells/mm(3) and 8 cells/mm(3), respectively. They had all received antiretroviral therapy for >4 years, including lopinavir/ritonavir for >8 months. The other risk factors were hypertriglyceridaemia (n=3), smoking addiction (n=2), alcohol consumption (n=2) and lipodystrophy (n=1). All three patients had heterozygous haemoglobin AS sickle cell disease (percentage of haemoglobin S 41%, 45% and 50%, respectively). The diagnosis of avascular osteonecrosis of the femoral head (unilateral n=2 and bilateral n=1) was documented by CT scan. Only one patient underwent surgical arthroplasty. In resource-limited settings, avascular osteonecrosis is uneasy to diagnose and unlikely to be appropriately treated. Physicians should be aware of its symptoms and risk factors, including HIV infection and antiretroviral therapy. Future studies should explore whether these risk factors might include haemoglobin AS sickle cell disease, a common trait in the West African general population.
Serge P Eholi??; Mariama Ouiminga; Eboi Ehui; Gustave Nzunetu; Songda I Ouattara; Alexis V Konan; Xavier Anglaret; Emmanuel Bissagn??n??
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Antiviral therapy     Volume:  14     ISSN:  1359-6535     ISO Abbreviation:  Antivir. Ther. (Lond.)     Publication Date:  2009  
Date Detail:
Created Date:  2009-11-17     Completed Date:  2010-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815705     Medline TA:  Antivir Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1011-4     Citation Subset:  IM    
Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, C??te d'Ivoire.
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MeSH Terms
Anemia, Sickle Cell / complications*,  genetics
Anti-Retroviral Agents / therapeutic use
Cote d'Ivoire
Femur Head Necrosis / diagnosis*,  etiology,  physiopathology
HIV Infections / complications*,  drug therapy
Hip / physiopathology
Middle Aged
Risk Factors
Reg. No./Substance:
0/Anti-Retroviral Agents

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