Cutaneous Manifestations of Hiv-Infection in Relation With Cd4 Cell Counts in Hadoti Region

Abstract

BACKGROUND: Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are frequently associated with mucocutaneous manifestations. However, there is paucity of data on skin disorders and association with CD4 cell counts from India. OBJECTIVE: To evaluate the occurrence of mucocutaneous disorders and their relationship with CD4 count. METHODS: A cross-sectional study was performed at Government Medical College Kota from January 2011 to January 2012. Collected information included demographic data, HIVassociated mucocutaneous disorders, CD4 cell count and highly active antiretroviral therapy (HAART). RESULTS: One hundred cases (male: female, 1.7: 1) were enrolled. The most common mode of HIV transmission was heterosexual (89%), followed by homosexual/bisexual contacts (5%), perinatal (5%) and blood transfusion (1%). The distribution of patients in terms of CD4 cell counts was as follows: 30% with less than 200 × 10 6 /L, 55% with between 200 and 500 × 10 6 /L, and 15% with more than 500× 10 6 /L. Most common skin disorders were fungal infection (46%), followed by bacterial infection (30%), viral infection (26%). Pruritic papular eruption (13%) was most common non infectious dermatoses followed by seborrheic dermatitis (8%). A CD4 cell count of less than 200×10 6 /L was significantly associated with a higher number of mucocutaneous disorders (P = 0.005) and the development of oral candidiasis [P = 0.005] and generalized seborrheic dermatitis (P = 0.005). There was no case of cutaneous malignancy in our study. CONCLUSION: A wide range of mucocutaneous disorders were observed in HIV-infected cases which are the indicator of AIDS and overall survival. A preponderance of infectious and inflammatory dermatoses with an absence of skin tumors characterized this study.