Cutaneous infections among Human Immunodeficiency Virus (HIV) - infected patients in a single center in Kuala Lumpur, Malaysia

Abstract

Background: Human immunodeficiency virus (HIV) infection is frequently associated with cutaneous infections. Objective: To determine the spectrum of dermatological infections among HIV positive patients, identify the causative microorganisms and CD4 count. Methods: This is a retrospective study conducted in a tertiary center. HIV-positive patients registered in 2013 to 2018 were identified from casemix database, those with suspected cutaneous infection were selected. Data was obtained from electronic and physical medical records. Results: A total of 27 patients were enrolled. Mean age was 38.61±11 years, 22(81.5%) were males and 5(18.5%) were females. Most patients 14(52%) developed more than one skin disease, there were a total of 46 diagnoses. The skin infections were fungal 11(24%), viral 4(8.7%) and bacterial 4(8.7%). Disseminated mycoses were mostly due to Penicillium marneffei 4(8.7%). Superficial fungal infections were due to Fusarium sp, Candida sp and Trichosporum sp . Cutaneus candidiasis constituted 3(6.47%). The average CD4 count in patients with fungal infections was 79 cells/mm3. Other skin diseases documented were adverse cutaneous drug reactions 8(17.4%) and pruritic papular eruption 5(11%). CD4 count was <200 cell/mm3 in 34(73.9%) of the dermatological illnesses encountered by the patients. Conclusion: Both disseminated and superficial fungal infections were common in our cohort. Penicillium marneffei caused majority of disseminated infections while superficial infections are due to moulds.