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World J Virol. Jan 25, 2023; 12(1): 1-11
Published online Jan 25, 2023. doi: 10.5501/wjv.v12.i1.1
Joint replacement and human immunodeficiency virus
Maryam Salimi, Peyman Mirghaderi, Seyedarad Mosalamiaghili, Ali Mohammadi, Amirhossein Salimi
Maryam Salimi, Department of Orthopedic Surgery, Shiraz University of Medical Sciences, Shiraz 71936-13311, Iran
Peyman Mirghaderi, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 7138433608, Iran
Seyedarad Mosalamiaghili, Ali Mohammadi, Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7136587666, Iran
Amirhossein Salimi, Department of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 7156893040, Iran
Author contributions: Salimi M performed the idea and revised the manuscript significantly; Mohammadi A drafted the manuscript; Mirghaderi P prepared the figures; Mosalamiaghili S revised the manuscript; Salimi A performed the literature review.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior authors or other coauthors who contributed their efforts to this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maryam Salimi, MD, Research Assistant, Department of Orthopedic Surgery, Shiraz University of Medical Sciences, Zand Avevue, Shiraz 71936-13311, Iran. salimimaryam7496@gmail.com
Received: July 26, 2022
Peer-review started: July 26, 2022
First decision: October 21, 2022
Revised: November 19, 2022
Accepted: December 8, 2022
Article in press: December 8, 2022
Published online: January 25, 2023
Processing time: 175 Days and 6.9 Hours
Abstract

The incidence of human immunodeficiency virus (HIV)-infected cases that need total joint replacement (TJR) is generally rising. On the other hand, modern management of HIV-infected cases has enabled them to achieve longevity while increasing the need for arthroplasty procedures due to the augmented dege-nerative joint disease and fragility fractures, and the risk of osteonecrosis. Although initial investigations on joint replacement in HIV-infected cases showed a high risk of complications, the recent ones reported acceptable outcomes. It is a matter of debate whether HIV-infected cases are at advanced risk for adverse TJR consequences; however, the weak immune profile has been associated with an increased probability of complications. Likewise, surgeons and physicians should be aware of the complication rate after TJR in HIV-infected cases and include an honest discussion of the probable unwelcoming complication with their patients contemplating TJR. Therefore, a fundamental review and understanding of the interaction of HIV and arthroplasty are critical.

Keywords: Human immunodeficiency virus; Arthroplasty; Infection; Joint replacement

Core Tip: The outcome and prevalence of complications are controversial among human immunodeficiency virus-infected cases who need arthroplasty. According to our literature review, total joint replacement procedures are recommended based on patient-specific factors such as viral load, CD4+ T-cell count, clinical classification, history of intravenous drug addiction, and the patient's overall health. Optimization with antiviral drugs is also suggested before elective arthroplasty.