Symptomatic myopathies in HIV-1 infected patients untreated with antiretroviral agents : A clinico-pathological study of 30 consecutive patients

Objective: To assess the clinico-pathological profile of symptomatic myopathies developing in HIV-1 infected patients before use of any antiretroviral therapy. Design: Prospective, cross-sectional study. Setting: University-referral, tertiary care Hospital. Patients: Thirty consecutively admitted, HIV-1 infected patients untreated with antiretrovirals and with clinically suspected skeletal myopathy or raised serum creatinkinase levels. Interventions: Clinical assesment of muscle strength and open muscle biopsy regarding to histopathological features. Results: Most of the HIV-1 infected patients were weaker when compared to the matched healthy control group. Only a few patients presented with myalgia. In one third of the cases an inflammatory condition (microvasculitis, myositis) was evident. In another third minor myopathic changes were observed, while in the remaining cases muscle biopsy was normal. Abnormal values of CK correlated poorly with pathologic diagnosis. Conclusions: In a significant proportion of HIV-1 infected symptomatic patients a specific treatment can be given when the existence of an inflammatory condition is diagnosed by muscle biopsy.