Rheumatological complications associated with the use of indinavir and other protease inhibitors

Several cases are reported of rheumatological pathology (temporomandibular dysfunction, frozen shoulder, Du-puytren’s disease, and tendinitis) most probably related to the intake of indinavir in HIV positive patients. A survey using an anonymous questionnaire of 878 people with HIV infection treated with antiretroviral drugs suggests that other protease inhibitors may also cause arthralgia. The use of protease inhibitors is an important part of themanagement of HIV infection. However, they have beenassociated with long term side effects such as lipodystro-phy. Other side effects, such as nephrolithiasis,1 hair loss, and paronychia,2 seem to be more specifically related to indinavir. Recently, ten cases of frozen shoulder associated with indina-vir have been reported.3–7 In this report we describe four cases of HIV infected patients who developed rheumatological complications dur-ing indinavir treatment.Moreover, in a survey of patients wit