Prevalence of psoriatic arthritis increasing among HIV-positive black Zambians

Increasing numbers of black patients in Zambia are presenting with psoriatic arthritis in association with HIV infection, according to researchers. Psoriatic arthritis has hitherto been rare among the indigenous black peoples of sub-Subharan Africa, they note.

Over a period of 40 months, Dr. Panganani Njobvu, of Stobhill Hospital, Glasgow, Scotland, and a colleague diagnosed psoriatic arthritis in 28 of 702 patients attending an arthritis clinic. Twenty-seven of these 28 patients were HIV-positive, they report.

In 20 patients, “arthritis and psoriasis developed simultaneously,” the authors state in their article, published in the July issue of the Journal of Rheumatology. Arthritis preceded psoriasis in four patients, and psoriasis preceded arthritis in the other three patients.

The authors report that most patients had extensive guttate-plaque psoriasis that did not remit with the onset of AIDS. The arthritis usually had an acute onset, “starting in the knees and/or ankle joint in 90% of patients during their first episode.” Amelioration of arthritis, although not psoriasis, typically occurred with onset of AIDS.

“This is the largest series yet recorded worldwide in association with HIV infection and this in a setting where psoriatic arthritis was extremely rare,” the authors comment.

Given the growing prevalence of psoriatic arthritis among HIV-positive black Zambians, the authors call for increased recognition of this condition “as an HIV-related disorder.”