Is septic arthritis and bone infection more common in HIV patients?
No, bone and joint infections from bacteria do not occur any more frequently in HIV-positive individuals compared with HIV-negative individuals. Intravenous drug abusers (IVDAs) and hemophiliacs are clearly at increased risk for septic arthritis however, independent of underlying HIV diagnosis. The most common bacterial organism is Staphylococcus aureus , especially in IVDAs, whereas Salmonella is most common in hemophiliacs. Mycobacterium tuberculosis arthritis and/or osteomyelitis can occur at any time in the course of HIV infection and may be multifocal (30%). Atypical mycobacterium and fungal musculoskeletal infections typically occur with severe immunosuppression (<100 cells/μL). Overall, bacterial joint infections are most common when the CD4+ count is >250 cells/μL, whereas opportunistic infections and polyarticular infections occur in patients with lower CD4+ counts. Osteomyelitis may occur independently at any bony site or coexist with septic arthritis.
