Dermatological manifestations of acquired immunodeficiency syndrome: an observational study among HAART naive patients from an ART centre of excellence

Abstract

Background: Dermatological manifestations can be a window to the clinical and immunological status of patients with HIV infection. Introduction of HAART has dramatically shifted the pattern of HIV associated dermatoses. The present study has been carried out to find out the same among HIV infected patients not started on HAART therapy.

Methods: Two hundred (200) HIV-positive, HAART-naïve patients attending ART centre of excellence were examined between November 2005 to July 2007, for the presence of mucocutaneous manifestations, correlation with CD4 count and analyzed using SPSS software.

Results: Out of the 200 patients examined, 64.5% (n=129) were found to have mucocutaneous manifestations. Out of those 129 patients 70 (54.3%) were male and 59 (45.7%) were females. Age of the patients ranged from 5 to 62 years with a mean±S.D of 32.08±11.48 yrs. Fungal infections (n=67, 51.9%) were the most common infectious dermatoses, followed by viral infections (n=35, 27.1%), scabies infestations (n=17, 13.2%) and bacterial infections (n=2, 1.6%). Of all the fungal infections, candidiasis (43.28%) was the commonest. Majority (64.5%) of the mucocutaneous manifestations were seen in patients with CD4 count <200 cells/mm³ and difference in CD4 count was significantly associated with cutaneous penicilliosis and oral hairy leukoplakia (p<0.044).

Conclusions: Infectious dermatoses remain as the far most common skin manifestations in HAART naïve patients. Lower the CD4 higher will be the incidence. Rare endemic infections like penicilliosis should be considered in differentials of umbulicated lesions in this part of the country.