Abstract
BackgroundAlthough the association between human immunodeficiency virus (HIV) and mucocutaneous diseases has been well studied within South African specialist centres, there is limited data from district-level hospitals. Available data may, therefore, fail to reflect the prevalence and full spectrum of dermatoses seen in people living with HIV (PLWH).ObjectivesTo determine the prevalence and spectrum of dermatoses seen in PLWH.MethodWe conducted a cross-sectional, descriptive study of 970 PLWH (men and women, ≥ 18 years old) accessing care at Karl Bremer Hospital, a district-level hospital located in the Western Cape province, South Africa, between 01 September 2016 and 28 February 2017.ResultsThe prevalence of mucocutaneous disease in this sample was 12.7% (95% confidence interval [CI] 0.11–0.15). Non-infectious dermatoses comprised 71.0% of the disorders. Pruritic papular eruption (20.0%) and seborrheic dermatitis (6.0%) were the most common non-infectious dermatoses. Tinea corporis (8.0%) and oral candidiasis (6.0%) were the most prevalent infectious dermatoses. There was no significant association between skin disease category (infectious or non-infectious dermatoses) and patient demographics (gender and ethnicity) or HIV-disease characteristics (CD4+ cell count, viral load and duration of antiretroviral therapy [ART]).ConclusionThis study provides valuable scientific data on the prevalence and spectrum of mucocutaneous disease in PLWH attending a South African district-level hospital. Prospective studies conducted in other district-level centres across the country are required to determine the lifetime prevalence and spectrum of dermatoses in PLWH in the ART era.
Highlights
The skin serves as an important clinical tool in the diagnosis and staging of patients with human immunodeficiency virus (HIV) and may be a marker of disease progression
Many skin and mucosal diseases are not unique to people living with HIV (PLWH), these patients can present with atypical features and dual or triple pathology.[3]
Most participants were black people (75%), had a CD4+ cell count ≥ 200 cells/μL (69%) and were on Antiretroviral therapy (ART) (74%). Of those participants on ART (n = 74), most (n = 65; 87.8%) were on an nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen, whilst nine (12.2%) participants were on a protease inhibitor (PI)-based regimen
Summary
The skin serves as an important clinical tool in the diagnosis and staging of patients with human immunodeficiency virus (HIV) and may be a marker of disease progression. As a result of ART, PLWH are living longer and healthier lives with a near-normal life expectancy.[5] Several of the HIV-associated dermatoses have declined during the ART era, but certain drug reactions and inflammatory skin conditions have increased.[4,6] Management of PLWH in the ART era includes addressing common http://www.sajhivmed.org.za. The association between human immunodeficiency virus (HIV) and mucocutaneous diseases has been well studied within South African specialist centres, there is limited data from district-level hospitals. Fail to reflect the prevalence and full spectrum of dermatoses seen in people living with HIV (PLWH)
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