Mucocutaneous manifestations in newly diagnosed cases of HIV, correlation with CD4 counts and WHO staging at a tertiary care center

Abstract

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Mucocutaneous infections have played an important role in initial diagnosis of HIV infection and in clinical staging of the disease. Mucocutaneous manifestations in HIV infected individuals are myriad and can serve as a main indicator of other problems. Health care personnel involved in HIV health care must therefore have a clear idea of type, pattern, and prevalence of skin diseases in their locality. <span lang="EN-US">The objective of the study was </span>to determine the various mucocutaneous manifestations in newly diagnosed cases of HIV and to correlate them with CD4 cell counts. The manifestations and CD4 cell counts are correlated with WHO staging of the disease.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong>Data was collected from all the newly diagnosed cases of HIV presenting to the Department of Dermatology. Thorough clinical examination was done and findings were noted. CD4 cell counts were performed by FACS counter and supportive laboratory tests were done for diagnosis of other skin manifestations<span lang="EN-US">.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>250 cases were enrolled with males 148 and 102 females. Most common age group was middle age group and hetero sexual route was the most common route of transmission. Bacterial skin infections were more common and candidiasis was most common among fungal infections. Herpes zoster was most common in viral infections. Significant correlation was observed between CD4 cell counts and WHO clinical staging of disease. Majority of infections were more common at advanced stage of HIV.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>To conclude, HIV-related mucocutaneous manifestations are a good clinical clue in diagnosis of advanced stages of HIV. Most of these manifestations can serve as diagnostic and prognostic markers in HIV infection. Management of HIV related mucocutaneous manifestations should always be precluded with a screening of CD4 cell counts. A lowered CD4 cell counts will prolong the duration of treatment and may significantly alter the outcome of the disease.</p>