What are the HIV associated muscle diseases?
Muscle involvement in HIV-infected patients is common, can occur at any stage of disease, and can be inflammatory or noninflammatory. HIV-related wasting syndrome (slim disease), a noninflammatory necrotizing myopathy, has been described in over 40% of HIV patients diagnosed with myopathy. Muscle biopsies show atrophy and necrosis without inflammation. The pathogenesis is unclear, with speculation regarding immune-mediated, metabolic, or nutritional factors. Since clinical presentation can be similar to other forms of HIV-associated myopathy, a muscle biopsy may be helpful to distinguish this condition from inflammatory myopathy or toxic (drug-induced) myopathy. Pre-ART HIV-infected patients more commonly develop PM, HIV-associated inclusion body myositis, nemaline rod myopathy (rare), pyomyositis, and HIV-related wasting syndrome. Patients treated with ART tend to develop drug-induced conditions, such as mitochondrial myopathy, rhabdomyolysis, and lipodystrophy. Rhabdomyolysis is of particular concern when protease inhibitors are used concurrently with statins.
