Fibromyalgia in HIV-positive patients in Nigeria: A cross-sectional prospective study

Int J Rheum Dis. 2021 Oct;24(10):1273-1281. doi: 10.1111/1756-185X.14195. Epub 2021 Jul 29.

Abstract

Background: Fibromyalgia is a chronic pain syndrome of unknown etiology characterized by chronic widespread musculoskeletal pain and tenderness. It affects the quality of life of patients and has been associated with the human immunodeficiency virus (HIV). The study aimed to determine the prevalence of fibromyalgia in HIV-positive patients and assess the effect of fibromyalgia on their functional status.

Methodology: This was a cross-sectional study comprising 160 treatment-naive HIV-positive patients and 160 age- and sex-matched HIV-negative controls. The diagnosis of fibromyalgia was based on the 2011 modification of the 2010 American College of Rheumatology diagnostic criteria by assessing the widespread pain index and symptom severity score. The severity of fibromyalgia was assessed with the revised fibromyalgia impact questionnaire.

Results: The prevalence of fibromyalgia in HIV-positive individuals was found to be 10.6%, which was significantly higher compared with controls (3.1%; P = .008). There was no significant association between fibromyalgia and age, gender, or occupation. There was a significant relationship between CD4 count levels (P < .001), WHO clinical stage (P < .001), and fibromyalgia. A statistically significant higher score on the Revised FM Impact Questionnaire was found in HIV-positive individuals with fibromyalgia (P < .001).

Conclusion: The study found that HIV-positive patients had a significantly higher incidence of fibromyalgia than controls and this was related to active indices of HIV disease. Fibromyalgia had a greater clinical impact on HIV patients than in controls. As a result, fibromyalgia should be identified and treated in people living with HIV.

Keywords: Nigeria; fibromyalgia; human immunodeficiency virus; musculoskeletal pain; treatment-naive.

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Fibromyalgia / diagnosis
  • Fibromyalgia / epidemiology*
  • Functional Status
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Nigeria / epidemiology
  • Pain Measurement
  • Prevalence
  • Prospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Young Adult