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We identified all patients who had \u22651 rheumatologist\u2010generated International Classification of Diseases, Ninth Revision (ICD\u20109) or Tenth Revision (ICD\u201010) code for RA and whose serum samples were tested for rheumatoid factor (RF) and anti\u2013cyclic citrullinated peptide (anti\u2010CCP) antibodies. To further confirm the diagnosis of RA, medical charts were reviewed to verify whether patients met the American College of Rheumatology\/European Alliance of Associations for Rheumatology 2010 criteria for RA. We recorded DMARD use and adverse effects during the first contiguous course of treatment (i.e., &gt;6 months of no interruption in DMARD treatment).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 56,250 patients with HIV and 116,944 uninfected individuals over 2,384,541 person\u2010years. Of the 2,748 individuals in this cohort who were reviewed for a diagnosis of RA based on ICD\u20109 or ICD\u201010 codes, incident RA was identified in 215 individuals, including 21 patients with HIV. The incidence rate ratio of RA for patients with HIV compared to uninfected individuals was 0.29 (95% confidence interval 0.19\u20130.48). Most of the patients diagnosed as having RA\u00a0(88%) were seropositive\u00a0for RA\u2010associated autoantibodies (RF and\/or anti\u2010CCP). However, high autoantibody titers were less frequent in RA patients with HIV compared to RA patients without HIV. In total, 5% of RA patients with HIV (1 of 21) had both high titers of anti\u2010CCP and high titers of RF, compared to 41% of uninfected individuals (81 of 194). DMARDs were prescribed in 71% of RA patients with HIV (15 of 21) compared to 94% of RA patients without HIV (183 of 194). There was no indication that the DMARD safety profile was worse among RA patients with HIV who were prescribed DMARDs (n = 10 assessed) compared to RA patients without HIV who were prescribed DMARDs (n = 158 assessed).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this cohort, incident RA was less common in patients with HIV compared to uninfected individuals. Moreover, compared to RA patients without HIV, the seropositivity rate and titers of RA\u2010specific autoantibodies were lower among RA patients with HIV, and those with HIV were prescribed DMARDs less frequently than those without HIV.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41802","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T07:10:52Z","timestamp":1622099452000},"page":"2189-2199","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Incident Rheumatoid Arthritis in HIV Infection: Epidemiology and Treatment"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6645-1144","authenticated-orcid":false,"given":"Jennifer S.","family":"Hanberg","sequence":"first","affiliation":[{"name":"Yale University, New Haven, Connecticut, and VA Connecticut Healthcare System  West Haven 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