Cutaneous Manifestations with Cd4 +T cell Counts in HIV Seropositive /Aids Patients - A Cross Sectional Study

Abstract

Background:AIDS is currently a burning problem in India and Worldwide. Cutaneous manifestations are seen frequently in HIV infected individuals causing significant morbidity. They are valuable clinical indicators and association is established between skin conditions and CD4+T cell counts. Objectives: Primary Objective -To find out the correlation between CD4 + T cell counts and skin manifestations. X Secondary Objective – To find out the prevalence of cutaneous manifestations in HIV/AIDS patients. Material & methods: A one year cross sectional study was conducted in 100 patients. All HIV seropositive patients with or without AIDS were included. The association between the CD4+T cell counts and skin manifestations was done using chi square test and Whitney – Mann test. Results: Among the 100 patients studied – 79% had cutaneous manifestations.38 were in the age group of 31-40yrs and male to female ratio was 1.32:1.Most of the patients acquired the infection through sexual mode of transmission (54= heterosexual & 5=Homosexual).39 were on HAART treatment. The non-infectious cutaneous manifestations like xerosis, seborrhoeic dermatitis, pruritic papular eruptions, drugrash, hair and nail changes were reported in maximum number of patients. Genital warts, multidermatomal herpes zoster, molluscum contagiosum, extensive dermatophytosis,vulvovaginal candidiasis, Norwegian scabies were among the common infections that were reported. Most of these patients had CD4 + T cell counts below 200 cells/μL.40% of patients had syst emic infect ions like tuberculosis, cryptococcalmeningitis, pneumocystis carinii pneumonia. Conclusion: The cutaneous manifestations are more with advanced stage and considered as clinical marker of immune suppression. This study revealed that non- infectious skin manifestations were most commonly seen and thus emphasizes the XI need for dermatological evaluation in HIV patients for early management and improved quality of life.