Prevalence of fibromyalgia in ambulatory HIV positive patients with musculoskeletal pain at Comprehensive Care Clinic, Kenyatta National Hospital

Background: Fibromyalgia is a rheumatic condition that is characterized by chronic widespread musculoskeletal pain with painful pressure points. There are other symptoms that are associated with this condition and they include fatigue, sleep disturbance and depression. The cause of this condition is unknown however chronic viral infections eg HIV have been associated with bromyalgia. Objective: This study aimed to determine the prevalence of fibromyalgia in HIV positive patients. Design: This was a cross-sectional descriptive study. Setting: The study was carried out at the Comprehensive Care Centre, Kenyatta National Hospital. Methods: The patients attending the clinic between the month of February 2013 and April 2013 were assessed for chronic musculoskeletal pain and subsequently fibromyalgia using the American College of Rheumatology criteria. Those found to have fibromyalgia were given the FIQR and those without were given the SIQR for comparison purposes. Clinical details eg WHO clinical stage, CD4 counts and HAART regimen for those on HAART were also documented. Results: A total of 380 patients were evaluated. The prevalence of fibromyalgia in HIV positive patients at the Comprehensive Care Centre, Kenyatta National Hospital was 68 (17.9%). The mean age of these patients was 42.2 years with a median of 40.5 years.There was a female preponderance of 60 (88.2%). Fibromyalgia was independently associated with female gender, OR=2.75, unemployment status, OR=5.68 and retired status, OR=3.01. A majority of the patients were in WHO clinical stage 3 and the mean CD4 count was 276.2. There was however no association between fibromyalgia and WHO clinical stage, CD4 count and use of HAART or the specific HAART regimens. The mean FIQR was 50.1 which was significantly higher than the mean SIQR score of 12.4 in those without fibromyalgia. Conclusion: Fibromyalgia is a prevalent rheumatologic condition among HIV positive patients with chronic musculoskeletal pain. It is also associated with a high FIQR score