A clinical study of mucocutaneous manifestation of HIV/AIDs and its correlation with CD4 count

Abstract

Background Acquired immune-deficiency syndrome (AIDS) is a fatal illness caused by a retrovirus known as Human Immunodeficiency Virus (HIV) which breaks down the immune system of the body, leaving the victim vulnerable to a host of life-threatening opportunistic infections, neurological disorders, or unusual malignancies. Dermatological disorders are health problems among HIV positive patients which present with a variety of manifestations. Skin diseases cause significant morbidity and may be initial signs of immunosuppression. They affect between 80 and 95% of HIV-infected patients, occurring at any time in the course of infection. Objective 1- To study the pattern of mucocutaneous manifestation of HIV infected patients attending Dermatology Outpatient Department (OPD) of Karnataka Institute Of Medical Sciences (KIMS) Hubballi. 2- To assess the relation of mucocutaneous manifestations of HIV infected patients with CD4 count. Methods All HIV positive patients with mucocutaneous manifestation attending Dermatology OPD, KIMS, Hubballi from December 2017 to May 2019 were enrolled. Results  In this study, the most common dermatosis was pruritic papular eruption (21%) with a mean CD4 count of 499.81±319.31 cells/mm3. Among viral infections, the most common infection was herpes genitalis (32.4%) with a mean CD4 count of 291.25±194.22 cells/mm3. The most common fungal infection was dermatophytosis (59.1%) with a mean CD4 count of 489.69±260.13 cells/mm3. The most common bacterial infection was pyoderma (73.7%) and the mean CD4 count was 485.21±308.30 cells/mm3. The most common parasitic infestation was scabies with a mean CD4 count of 375.60±117.59 cells/mm3. Among malignancies, only two cases of basal cell carcinoma was seen in this study and the mean CD4 count was 89.50±57.28 cells/mm3. Conclusion The skin manifestations in HIV can serve as an important marker for underlying immunodeficiency state. The CD4 count of a patient can be used to know the level of immunosuppression as different dermatosis are seen at various stages of HIV infection.