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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



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Avascular Necrosis of Bone in Patients with Human Immunodeficiency Virus Infection: A Report of Six Cases and a Review of the Literature [Brown P and Crane L. CID 2001;32:1221]: The authors report their experience with avascular necrosis in six patients with HIV infection encountered at Wayne State in 1998-99, and then add this series to a review of the reported cases from 1990 to 1999. This gives a total of 37 cases, which are summarized in the following table:

Avascular Necrosis in Patients with
HIV Infection: Literature Review of 37 Cases
Age (mean) 35.4 years*
CD4 cell count (mean) 481/mm3
No. PI therapy 10/18 (56%)
Reported before 1995 15 (41%)
Hip involvement 31 (84%)

Comment: This report shows that the average CD4 cell count was 480/mm3, and the primary site of involvement was the hips (84% of cases) followed by shoulders and knees. Perhaps most importantly, PI therapy was apparently not given to 25 (67%) either because they were reported before 1995 (15 cases) or because therapeutic histories were provided and did not indicate PI treatment (10 cases).
posted 5/16/2001





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