HIV Infection, Opportunistic Infections, and Vascular Disease
A wide range of inflammatory vascular diseases, including polyarteritis nodosa, Henoch- Schonlein purpura, and drug-induced hypersensitivity vasculitis may develop in HIV-infected individuals.
Kawasaki-like syndrome [42] and Takayasu’s arteritis [43] have also been described. The course of vascular disease may be accelerated in HIV-infected patients because of atherogenesis stimulated by HIV-infected monocyte-macrophages, possibly via altered leukocyte adhesion or arteritis [44].Some patients with AIDS have a clinical presentation resembling systemic lupus erythematosus (SLE), including vasculitis, arthralgias, myalgias, and autoimmune phenomena with a low-titer positive antinuclear antibody, coagulopathy with lupus anticoagulant, hemolytic anemia, and thrombocytopenic purpura. Hypergammaglobulinemia from polyclonal B-cell activation may be present, but often diminishes in the late stages of AIDS. Specific autoantibodies to double-stranded DNA, Sm antigen, RNP antigen, SSA, SSB and other histones may be found in a majority of HIV-infected persons, but their significance is unclear [44].