{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:11:55Z","timestamp":1790345515691,"version":"4.1.0"},"reference-count":31,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T00:00:00Z","timestamp":1579651200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2019,12,20]]},"published-print":{"date-parts":[[2020]]},"abstract":"<jats:p><jats:italic>Aim<\/jats:italic>: The aim was to assess the seroprevalence of Human Immunodeficiency Virus (HIV) in non-haemophilic patients undergoing primary Total Joint Arthroplasty (TJA) at an academic hospital in South Africa.<\/jats:p>\n<jats:p><jats:italic>Methods<\/jats:italic>: A retrospective review of all Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) patients from January 2017 to December 2018 was conducted. All patients awaiting TJA were offered HIV screening and their demographic data were recorded. Consenting patients were tested or the refusal of testing was documented. The CD4+ T-cell count (CD4+) and viral load (VL) was measured for all HIV-positive patients and newly diagnosed patients were initiated on Highly Active Antiretroviral Treatment (HAART).<\/jats:p>\n<jats:p><jats:italic>Results<\/jats:italic>: We included 1007 patients in the study. The TJA population HIV seroprevalence was 10.7% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0108). The seroprevalence for THA was 14.9% (<jats:italic>n<\/jats:italic>\u00a0=\u00a078) and that for TKA was 6.2% (<jats:italic>n<\/jats:italic>\u00a0=\u00a030). There were 93 patients (9.2%) who refused screening. There were 12 (15.4%) and 3 patients (10%) that were newly diagnosed in the THA and TKA seropositive populations, respectively. The average CD4+ for THA and TKA was 569 cells\/mm<jats:sup>3<\/jats:sup> (105\u20131320) and 691 cells\/mm<jats:sup>3<\/jats:sup> (98\u20131406), respectively. The VL was undetectable in 75.9% (<jats:italic>n<\/jats:italic>\u00a0=\u00a082) of HIV-positive patients. Overall 12 HIV-positive patients (11.12%) had CD4+ &lt;200 cells\/mm<jats:sup>3<\/jats:sup>, 8 of these patients (66%) were newly diagnosed. The average age of the seropositive population was 58\u00a0\u00b1\u00a06.5 years and 66\u00a0\u00b1\u00a08.5 years for THA and TKA, respectively (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.03). Femoral head osteonecrosis was the underlying pathology for 65.38% (<jats:italic>n<\/jats:italic>\u00a0=\u00a051) of seropositive patients for THA.<\/jats:p>\n<jats:p><jats:italic>Conclusion<\/jats:italic>: The seroprevalence of HIV in patients undergoing THA in our South African institution is greater than the seroprevalence in the general population. The seroprevalence of HIV in THA is significantly greater than that in TKA. This may reflect the association between HIV, HAART and hip joint degeneration. Our findings draw attention to the significant burden HIV has on TJA.<\/jats:p>","DOI":"10.1051\/sicotj\/2019042","type":"journal-article","created":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T09:04:08Z","timestamp":1579683848000},"page":"3","source":"Crossref","is-referenced-by-count":6,"title":["The seroprevalence of HIV in patients undergoing lower limb Total Joint Arthroplasty (TJA) in South Africa"],"prefix":"10.1051","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9172-911X","authenticated-orcid":false,"given":"Zia","family":"Maharaj","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurek Rafal Tomasz","family":"Pietrzak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkhodiseni","family":"Sikhauli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"van de Jagt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lipalo","family":"Mokete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"250","published-online":{"date-parts":[[2020,1,22]]},"reference":[{"issue":"8","key":"R1","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/j.apmr.2008.10.035","volume":"90","author":"Tian","year":"2009","journal-title":"Arch Phys Med Rehabil"},{"key":"R2","unstructured":"American Academy of Orthopaedic Surgeons, American Joint Replacement Registry (AJRR) (2018) Fifth AJRR Annual Report on Hip and Knee Arthroplasty Data."},{"key":"R3","unstructured":"Canadian Joint Replacement Registry, Discharge Abstract Database, Hospital Morbidity Database and National Ambulatory Care Reporting System, 2017\u20132018. Canadian Institute for Health Information."},{"issue":"3","key":"R4","doi-asserted-by":"crossref","first-page":"A86","DOI":"10.1016\/j.jval.2016.03.1795","volume":"19","author":"Odum","year":"2016","journal-title":"Value Health"},{"key":"R5","unstructured":"National Joint Registry (NJR) Editorial Board. NJR 15th Annual Report 2018. Published 25 September 2018. https:\/\/www.hqip.org.uk\/resource\/national-joint-registry-15th-annual-report-2018 (date last accessed 10 April 2019)."},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Davies PSE, Graham SM, Maqungo S, Harrison WJ (2019) Total joint replacement in sub-Saharan Africa: A systematic review. Trop Doct 1\u20139.","DOI":"10.1177\/0049475518822239"},{"key":"R7","unstructured":"No authors listed. UNAIDS factsheet July 2018. https:\/\/www.aidsinfo.unaids.org (date last accessed 27 December 2018)."},{"key":"R8","unstructured":"Pharris A, Stengaard A, Amato-Gauci AJ, et al. European Center for Disease Prevention and Control (ECDC) (2018) HIV\/AIDS Surveillance in Europe 2018\u20132017 Data. Copenhagen, World Health Organization. https:\/\/www.ecdc.europa.eu\/en\/publications-data\/hivaids-surveillance-europe-2018-2017-data (date last accessed 10 April 2019)."},{"key":"R9","unstructured":"No authors listed, Center for Disease Prevention and Control (CDC). HIV Surveillance Report: Diagnoses of HIV Infection in the United States and Dependent Areas, 2017, vol. 29. https:\/\/www.cdc.gov\/hiv\/pdf\/library\/reports\/surveillance\/cdc-hiv-surveillance-report-2017-vol-29.pdf (date last accessed 10 April 2019)."},{"key":"R10","unstructured":"No authors listed, Public Health England. 2019. HIV in the UK 2016 Report. https:\/\/www.gov.uk\/government\/publications\/hiv-in-the-united-kingdom (date last accessed 10 April 2019)."},{"issue":"1","key":"R11","doi-asserted-by":"crossref","first-page":"776","DOI":"10.4102\/sajhivmed.v18i1.776","volume":"18","author":"Meintjes","year":"2017","journal-title":"South Afr J HIV Med"},{"issue":"11","key":"R12","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.2106\/JBJS.L.00269","volume":"95","author":"Lin","year":"2013","journal-title":"J Bone Joint Surg Am"},{"issue":"10","key":"R13","first-page":"1648","volume":"56","author":"Walker-Bone","year":"2017","journal-title":"Rheumatology (Oxford)"},{"key":"R14","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/s11914-012-0125-0","volume":"10","author":"Rothman","year":"2012","journal-title":"Curr Osteoporos Rep"},{"issue":"9","key":"R15","doi-asserted-by":"crossref","first-page":"e8","DOI":"10.2106\/JBJS.RVW.17.00029","volume":"5","author":"Dimitriou","year":"2017","journal-title":"JBJS Rev"},{"issue":"11","key":"R16","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2106\/JBJS.RVW.15.00117","volume":"4","author":"Shah","year":"2016","journal-title":"JBJS Rev"},{"issue":"9","key":"R17","doi-asserted-by":"crossref","first-page":"777","DOI":"10.2106\/JBJS.16.01435","volume":"100","author":"Tan","year":"2018","journal-title":"J Bone Joint Surg"},{"issue":"2","key":"R18","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1016\/j.arth.2018.09.050","volume":"34","author":"Zainul-Abidin","year":"2019","journal-title":"J Arthroplasty"},{"issue":"4","key":"R19","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.otsr.2016.02.012","volume":"102","author":"Winkelmann","year":"2016","journal-title":"Orthop Traumatol Surg Res"},{"key":"R20","first-page":"455","volume":"10","author":"Mineiro","year":"1997","journal-title":"Acta Med Port"},{"key":"R21","first-page":"1245","volume":"63","author":"Joyce","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R22","unstructured":"No authors listed. National Health Laboratory Services. http:\/\/www.nhls.ac.za\/?page=hiv&id=55 (date last accessed 15 September 2018)."},{"key":"R23","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1302\/2046-3758.69.BJR-2017-0066.R2","volume":"6","author":"Cheng","year":"2017","journal-title":"Bone Joint Res"},{"key":"R24","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1302\/0301-620X.91B3.21706","volume":"91","author":"Lubega","year":"2009","journal-title":"J Bone Joint Surg Br"},{"key":"R25","first-page":"153","volume":"37","author":"Mulla","year":"2010","journal-title":"Med J Zambia"},{"issue":"2","key":"R26","first-page":"30","volume":"10","author":"Sefeane","year":"2011","journal-title":"SA Orthop J"},{"key":"R27","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.4103\/0366-6999.161364","volume":"128","author":"Zhao","year":"2015","journal-title":"Chin Med J (Engl)"},{"key":"R28","unstructured":"Libman H (2018) Surgical Issues in HIV Infection. https:\/\/www.uptodate.com\/contents\/surgical-issues-in-hiv-infection (date last accessed 27 October 2018)."},{"key":"R29","unstructured":"No authors listed. STATISTICAL RELEASE P0302 Mid-Year Population Estimates 2017. http:\/\/www.statssa.gov.za\/?page_id=1854&PPN=P0302&SCH=7048 (date last accessed 27 December 2018)."},{"issue":"2","key":"R30","first-page":"113","volume":"17","author":"S\u00e1nchez","year":"1998","journal-title":"P R Health Sci J"},{"key":"R31","first-page":"274","volume":"29","author":"Yeganeh","year":"2015","journal-title":"Med J Islam Repub Iran"}],"container-title":["SICOT-J"],"original-title":[],"link":[{"URL":"https:\/\/www.sicot-j.org\/10.1051\/sicotj\/2019042\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T07:58:59Z","timestamp":1584691139000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.sicot-j.org\/10.1051\/sicotj\/2019042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":31,"alternative-id":["sicotj190073"],"URL":"https:\/\/doi.org\/10.1051\/sicotj\/2019042","relation":{},"ISSN":["2426-8887"],"issn-type":[{"value":"2426-8887","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]}}}