Byline: P. Ashwini, Jayadev. Betkerur, Veeranna. Shastry
Introduction: HIV is associated with various mucocutaneous manifestations which may be the first pointers toward HIV and can also be prognostic markers for disease progression. This study was done to note the different mucocutaneous lesions present in HIV and their relation to total lymphocyte count (TLC). Methodology: Three hundred and seventy-nine HIV patients attending the Department of Dermatology, Venereology, and Leprosy were included in the study. They were screened for the presence of any mucocutaneous lesions. TLC in patients presenting with mucocutaneous lesions was done and also CD4 count was done wherever possible. Results: Among 379 patients, 53.8% developed mucocutaneous manifestations. Male: female ratio was 2.2:1. Majority of patients belonged to 20-39 years age group. Among mucocutaneous manifestations, oral candidiasis was the most common, followed by herpes zoster and dermatophytoses. Adverse drug reactions were noted in few. The majority of patients had TLC <1500/mm3 and CD4 <200. Conclusion: Mucocutaneous manifestations are common and have varied presentation in HIV/AIDS. Patients with mucocutaneous manifestations were clustered at lower TLC and CD4 count. Like CD4 count, TLC can be considered as a marker for disease progression.
Dermatological manifestations are seen at every stage of HIV/AIDS and are often the presenting features. These manifestations may act as marker of disease progression.
CD4 cell count and CD4 percentage are key markers for determining disease progression in HIV-infected patients. Many studies had demonstrated a reasonable correlation between total lymphocyte count (TLC) and CD4 count. It was recommended that TLC can be used as a laboratory marker to initiate antiretroviral therapy in resource-poor settings, where CD4 is not available.
Aims and objectives
*To study the prevalence of various mucocutaneous manifestations in patients with HIV/AIDS *To determine the correlation between TLC and mucocutaneous manifestations in patients with HIV/AIDS.
The study population included all HIV-positive patients, who attended Department of Dermatology, Venereology, and Leprosy of JSS Hospital, Mysore. The patients were screened for mucocutaneous manifestations, over a period of 2 years. After an informed consent, a detailed history and complete examination was done according to preformed pro- forma.
Hemoglobin percentage, complete blood count, peripheral blood smear, urine analysis, and TLC was estimated. Investigations pertaining to opportunistic infection were done whenever necessary. CD4 count was done in patients who were willing.
Patients were followed up regularly and complete cutaneous and systemic examination was performed. In patients, presenting with mucocutaneous manifestations, the TLC was done. CD4 cell count was done whenever possible.
The prevalence rate of mucocutaneous manifestations was estimated. The statistical significance was evaluated using Chi-square test. The significance level used was at 95% level.
The mucocutaneous manifestations were classified into major six groups. The distribution of the mucocutaneous manifestations according to CD4 count and the total lymphocyte was prepared. The mean and standard deviation of CD4 count and TLC were estimated for disease categories, and ANOVA was applied to test the significant difference between manifestation category. The Pearson correlation coefficient was estimated for CD4...