Manifestations In HIV Positive Patients Research Articles

A study of ocular manifestations in HIV positive patients

: The present study aimed to determine the prevalence and pattern of ocular manifestation in HIV positive patients and to correlate ocular lesions with CD4 counts in HIV positive patients. The study was conducted as an observational study on seropositive HIV patients attending ART center and OPD department of ophthalmology during the study period of 2 years. Detailed sociodemographic and clinical history was obtained. Patients were subjected to thorough ophthalmologic evaluation and necessary investigations and findings were noted. Ocular manifestations could be observed in 36 (52.2%) cases. Among them, unilateral ocular manifestations were observed in 11 (15.9%) cases and bilateral involvement in 25 (36.2%) out of 69 patients. A wide spectrum of ocular manifestations were observed, most commonly of posterior segment. Ocular manifestations were not significantly associated with CD4 count (p>0.05) except CMV retinitis which was significantly associated with lower CD4 count (<150 in 14.3% cases). Papilledema was significantly associated with higher CD4 count (p<0.05).Ocular manifestations in HIV positive patients has a wide range of presentation. Every HIV patient must be educated about their ocular condition and should be advised to undergo regular ophthalmic examinations. Health care professionals also should be educated and trained in every aspect so as to pick up early cases of ophthalmic manifestations of HIV and should have coordination with ART center for easy assessment, detection and treating of vision-threatening ocular lesions at the earliest possible.

CARDIOVASCULAR MANIFESTATIONS IN HIV POSITIVE PATIENTS IN A TERTIARY CARE HOSPITAL, CENTRAL INDIA

Background: Acquired immune deficiency syndrome (AIDS) is one of the major public health problem in india .HIV estimates report (2019)(1) of the Government, India is estimated to have around 23.49 lakh people living with HIV/AIDS (PLHIV) in 2019 . in Chhattisgarh it is 42520&HIV incidence per 1,000 uninfected population is 0.1 .with the recent advancements in therapy early mortality in HIV cases are significantly reduced but cardiovascular abnormalities are frequently seen as the disease progress and is associated with decreased quality of life.
 Aims and objective: To know the pattern and prevalence of various cardiovascular manifestations in HIV positive patients and its association with CD4 count, WHO stage of disease and ART
 Material and Methods: for the period of 1.3 years from JANUARY 2019 TO APRIL 2020studyis conducted in the Department of Medicine, PT.JNM Medical College and Dr. BRAMH, Raipur. A total of 137 HIV positive patients of age>18 years, all are on ART are included.patients included in the study underwent detailed history taking, clinical examination and investigations. Details of the history, clinical examination and investigations were noted in the proforma. The cardiovascular examination in the form of chest x-ray, ECG, 2D echocardiography and NT-ProBNP was done and their correlationswith CD4 count and WHO disease stage is studied accordingly. Electrocardiogram, chest x-ray and 2D echocardiography was done immediately following blood investigation.
 Result: Majority (45.25%) of the patients involved in this study were in age group of 31-45 year with the overall average mean age of 38.86 years. Male to female ratio was 3.1:1. On x-ray cardiomegaly found in 25.5% pts baseline ECG abnormalitities seen in 47.4% pts . echocardiographic abnormality seen in 56.2% pts .The commonest finding in our study is valvular abnormalities in 55 pts (40.1%) followed by diastolic dysfunction in 45 pts(32.8%). Other less common cardiac manifestations in decreasing order of frequency were reduced LVEF in 33 pts(24%), pericardial effusion in 15 pts (10.9%),left ventricular hypertrophy in 13 pts (9.4%), pulmonary arterial hypertension in 10 pts (7.2%)and regional wall motion abnormality in 9 pts (6.5%). We found A strong statistical correlation found between CD4 count and pericardial effusion in 2D-ECHO (p= 0.0410023). Also strong statistical correlation (p=0.016456) is found between the WHO stage of disease and cardiomegaly, strong statistical correlation found between WHO staging of disease and QRS abnormalities (p= 0.02551) and inverted T wave (p= 0.000528), strong statistical correlation found between WHO stage of disease and pulmonary arterial hypertension in 2D-ECHO (p=0.006832). And statistical association found between WHO stage of disease and regional wall motion abnormality (RWMA) in 2D-ECHO (p=0.002541).
 Conclusion: The results of the study indicate that cardiovascular abnormalities in HIV infected patients are common. Cardiac involvement and cardiovascular complications are commonly seen in HIV-infected patients and can present without any clinical manifestation. The common cardiovascular manifestation seen in our study patients is valvular leaks, regional wall motion abnormality, pericardial effusion, reduced EF etc. The incidence of cardiovascular manifestations increases as the disease progresses and CD4 count decreases.
 Keywords: Prevalence, Cardiovascular, Abnormalities & HIV.
 Study Designed: Cross Sectional Observational Study.

Study on Clinical Spectrum of Neurological Manifestations in HIV Positive Patients from a Tertiary Health Care Unit

Study on Clinical Spectrum of Neurological Manifestations in HIV Positive Patients from a Tertiary Health Care Unit

A Review of the Use of Biological Agents in Human Immunodeficiency Virus Positive Patients With Rheumatological Diseases.

After approval, initial biologics etanercept, infliximab, and adalimumab became useful in the therapeutic armamentarium to treat rheumatoid arthritis (RA) patients who had an inadequate response to disease-modifying anti-rheumatic drugs (DMARDs). However, all phase-III clinical trials submitted to the FDA, by design, excluded patients who were human immunodeficiency virus (HIV) positive. They are another subset of patients with low immunity due to their HIV-positive status. Very little information is available about the use of biologics in this new group of patients if they fail to respond to DMARDS. The available literature is limited to case reports about HIV-positive RA patients with reported side effects. These side effects range from no opportunistic infections (OIs) in some to acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulopathy (DIC) reported in others. Some HIV cases may initially present with rheumatological manifestations. With growing epidemiologic evidence of frequent joint manifestations in HIV-positive patients, HIV testing should be done more frequently in patients with RA, even those who deny risk factors for HIV. This review may help develop future guidelines on how to manage HIV-positive RA patients.

Study of prevalence of ocular manifestations in HIV positive patients.

HIV/AIDS is a disorder which affects multiple systems in our body but ophthalmic manifestations do occur in 70-80% of patients sometime during their lifetime. Eye is affected either directly by HIV virus or indirectly through various opportunistic infections. HIV related ophthalmic manifestations are wide and can affect any part of eye from a dnexal disorders to posterior segment diseases including the optic nerve and the optic tract. This study was done to know the prevalence of ocular manifestations in the known HIV positive case & to correlate the ocular manifestations in HIV positive patients with their CD4+ lymphocyte count and duration of disease. In the present study, we examined 200 known cases of HIV infection who attended the Out Patient Department of Government Eye Hospital, Amritsar, Punjab. Detailed ocular examination was done and the findings were correlated with CD4+ count and duration of the disease. In the present study it was found that dry eye and HIV retinopathy were amongst the most common ocular manifestations accounting for 20.5% and 20% of the total cases. Next in the series was neuro ophthalmic complications which include dpapilledema, optic nerve atrophy, papillitis and also third nerve abnormalities. It consisted of 5.5% of the total cases. Almost equal in incidence was anterior uveitis consisting of 5% of the total. Next of importance was CMV retinitis of which 5 cases were seen which constituted 2.5% of the total and all these cases were observed in the patients with CD4+ count less than 50/mm3. p value for this was 0.008 which was statistically significant. Few cases of blephar it is, conjunctivitis, cellulitis, herpes zoster ophthalmic us and keratitis were also found which consisted of 2.5%, 0.5%, 1%,3%, and 2% respectively. Any HIV-infected person who at any stage experiences ocular symptoms also should get competent ophthalmologic care at the earliest. Any delay in treatment can lead to permanent visual loss. An improved coordination between two branches of ophthalmology and HIV medicine will need long coordination against this dreadful disease.

A prevalence study of ocular manifestations in HIV positive patients on highly active anti-retroviral therapy

Background: Among 40 million cases worldwide, 50-75% of patients have at least one ocular manifestation in their lifetime. Many of ocular infections are treatable with therapeutic agents. Ocular manifestations invariably reflect systemic disease and can be the initial manifestations of HIV in many cases. Understanding of ocular sequel of HIV infection can lead to the early diagnosis and effective treatment. This study emphasizes on the need of developing a specific ophthalmic examination for the management of ocular manifestations in HIV infected patients.Methods: Cross sectional and observational study of 100 HIV positive participants on HAART were done irrespective of presence or absence of ocular symptoms. Participants were examined for complete ocular examination. Prevalence find out using chi-square test, find p values and ensuring statistical significance.Results: In our study, prevalence of ocular manifestation in HIV positive patients receiving HAART was 39%. Out of them, 20% adnexal involvement, 28% anterior segment involvement, 33% posterior segment involvement, 11% neuro-ophthalmic abnormality, 4% orbital involvement were present. 76% patients belonged to WHO clinical stage 2 and 3. 51% had CD4+ T cell counts <200 cells/µl.Conclusions: Posterior segment followed by anterior segment are the most commonly encountered ocular manifestations of HIV infection. Low CD4 count is good predictor for ocular manifestations in HIV positive patients. Higher WHO stage is also directly related with the severity of the ocular symptoms. Routine baseline ophthalmic screening to all HIV positive patients are necessary to prevent ocular morbidity.

A prevalence study of ocular manifestations in HIV positive patients on highly active anti-retroviral therapy

Background: Among 40 million cases worldwide, 50-75% of patients have at least one ocular manifestation in their lifetime. Many of ocular infections are treatable with therapeutic agents. Ocular manifestations invariably reflect systemic disease and can be the initial manifestations of HIV in many cases. Understanding of ocular sequel of HIV infection can lead to the early diagnosis and effective treatment. This study emphasizes on the need of developing a specific ophthalmic examination for the management of ocular manifestations in HIV infected patients. Methods: Cross sectional and observational study of 100 HIV positive participants on HAART were done irrespective of presence or absence of ocular symptoms. Participants were examined for complete ocular examination. Prevalence find out using chi-square test, find p values and ensuring statistical significance. Results: In our study, prevalence of ocular manifestation in HIV positive patients receiving HAART was 39%. Out of them, 20% adnexal involvement, 28% anterior segment involvement, 33% posterior segment involvement, 11% neuro-ophthalmic abnormality, 4% orbital involvement were present. 76% patients belonged to WHO clinical stage 2 and 3. 51% had CD4+ T cell counts <200 cells/µl. Conclusions: Posterior segment followed by anterior segment are the most commonly encountered ocular manifestations of HIV infection. Low CD4 count is good predictor for ocular manifestations in HIV positive patients. Higher WHO stage is also directly related with the severity of the ocular symptoms. Routine baseline ophthalmic screening to all HIV positive patients are necessary to prevent ocular morbidity.

Clinical study of ophthalmological manifestations in HIV positive patients attending tertiary care hospital

Clinical study of ophthalmological manifestations in HIV positive patients attending tertiary care hospital

Ocular manifestations in patients attending antiretroviral therapy centre at a tertiary care hospital in Himachal Pradesh, India.

Background & objectives:Ocular manifestations in HIV/AIDS patients range from adnexal disorders to the posterior segment disease. This study was aimed to evaluate the ocular manifestations, including vision-threatening manifestations in HIV-positive patients attending an antiretroviral therapy centre (ART) of a tertiary care hospital in north India and its association with the CD4+ cell count.Methods:This cross-sectional study was conducted in the department of Ophthalmology in collaboration with the ART centre. An equal number of patients were selected from each year i.e., 30 patients each from those registered in the year 2010 till 2015. These patients were selected randomly from the register using systematic randomization. Hence, a total of 150 patients were examined for ocular manifestations. All the patients included in this study were on highly active ART.Results:Of the 150 patients examined, 53 per cent were females and 47 per cent were males. Heterosexual transmission was the most common mode of transmission in 126 (84%) patients. Maximum number of patients was in the age group of 31-40 yr. Ocular manifestations were present in 53 [35.3%; 95% confidence interval (CI): 28-43%] patients. Twelve (8%; 95% CI: 4-12%) patients had lid and adnexal manifestations. Anterior-segment manifestations were present in 20 (13.3%; 95% CI: 8-19%) patients. Posterior-segment manifestations were present in 21 (14%; 95% CI: 8-20%) and vision-threatening posterior-segment ocular lesions were present in 14 per cent of the patients. Univariate logistic regression showed a significant (P <0.001) inverse association of CD4+T-cell count with the vision-threatening posterior-segment ocular lesions.Interpretation & conclusions:Routine ocular examination may be done in all the HIV/AIDS patients to detect and treat vision-threatening ocular lesions at the earliest.

Assessment of neurological manifestations in HIV positive patients

Assessment of neurological manifestations in HIV positive patients

Infekce HIV jako nové onemocnění vnitřního lékařství

Modern antiretroviral treatment belongs to the greatest success of current medicine. HIV infection has gone from a death sentence to a manageable chronic disease which develops several decades. Thanks to treatment advances, people with HIV can and do live long and full lives. In the last two decades, the incidence AIDS defining illnesses have been dramatically reduced especially opportunistic infections and malignancies, whereas the role of non-infection comorbidities has risen than age-matched HIV uninfected adults. These comorbidities include cardiovascular diseases, venous and arterial thrombosis, metabolic disorders, chronic liver and renal diseases, nervous system disorders, osteoporosis and some cancers. This relatively large group of diseases is known as non-AIDS defining or indicating diseases and these diseases are associated in HIV uninfected general population with older age and ageing Most HIV positive individuals on antiretrovirals present an abnormal level of immune activation, inflammation and hypercoagulable condition. These hallmarks are typically seen in older HIV uninfected general population and are associated with aging and the immunosenescent phenotype. The explanation for this phenomenon is unclear. There are multiple factors, which may apply pathophysiologically, including the residual immune dysregulation syndrome and antiretrovirals alone. It is clear that changes in the nature of chronic HIV infection put it in internal medicine. Cardiology, internal medicine, geriatric and oncology syndromes are dominating manifestations in HIV positive patients on antiretrovirals. Care management for HIV infected individuals will need to draw on a wide range of medical disciplines in diagnosis and treatment. Clarification of these phenomena would be beneficial for the treatment of these non-infectious diseases in HIV positive and as well in HIV negative general population.Key words: antiretroviral therapy - HIV infection - immune dysregulation - immunosenescence - non-AIDS disease.

Correlating CD4 count with mucocutaneous manifestations in HIV-positive patients: A prospective study.

Background:Mucocutaneous findings may be the presenting symptoms in HIV-afflicted individuals. A multitude of mucocutaneous diseases also occurs during the course of the ailment, with some conditions being classed as disease defining. They include infectious diseases and noninfective inflammatory and neoplastic dermatoses. With progressive fall in CD4 count, there is a change in the types of mucocutaneous lesions encountered.Aim:This study aims to statistically correlate the CD4 counts with the mucocutaneous manifestations in 100 HIV-positive patients.Materials and Methods:A total of 100 cases of HIV-positive patients with skin and mucous membrane manifestations were selected serially. A complete history was taken, clinical examination was done, and the CD4 count was noted. Patients were divided into four groups (Groups I, II, III, IV) with different ranges of CD4 values, namely, <50, 50–200, 201–500, >500, respectively.Results:The distribution of study population in CD4 ranges showed that majority (47%) of the study population had CD4 count between 201 and 500, and 29% of the study group had CD4 count between 50 and 200 cells. Almost 21% of the patients had the count > 500 cells and 3% had cell count < 50. Majority of the infectious and non-infectious dermatoses were common in the CD4 count between 201–500 (Group III) and 50–200 (Group II). In the study groups, 52 cases (52%) were on antiretroviral therapy (ART), and the remaining 48 cases (48%) were not on ART at the time of diagnosis of mucocutaneous manifestations. Out of 48 ART-naïve cases, 23 patients were screened and newly diagnosed at the outpatient department (OPD) based on the mucocutaneous manifestations. Most of the patients with multiple mucocutaneous conditions were in the CD4 count <200, whereas single manifestation was seen predominantly in CD4 count >200.Conclusion:Statistically significant association with the CD4 count was seen in herpes zoster ophthalmicus, genital wart, genital herpes, vaginal discharge syndrome, scabies, pyoderma, dermatophytosis, Hansen's disease, herpetic gingivostomatitis, seborrhoeic dermatitis, lichen planus, and drug reactions. These dermatoses may indicate the worsening of immune status and the need for regular monitoring with periodical CD4 counting. Occurrence of dermatoses such as photosensitive eczema, drug reaction, lichen planus, Type I lepra reaction, and herpes zoster ophthalmicus in patients on ART may be due to IRIS. To avoid the more frequent occurrence of infectious dermatoses and to reduce the development of IRIS with ART, all HIV-positive cases may be started on ART at higher CD4 count. Screening for HIV infection is suggested whenever the following conditions are seen: persistent oral candidiasis, atypical manifestations of zoster, herpes zoster ophthalmicus, herpetic gingivostomatitis and MC in adults, exaggerated IBA, and extensive seborrhoeic dermatitis.

Eye changes among HIV positive patients on antiretroviral therapy in Nepal.

To find out eye findings among HIV positive patients in the era of antiretroviral therapy. Method This Hospital based cross sectional descriptive study was carried at B. P. Koirala Lions Centre for Ophthalmic Studies. Patient profile, WHO clinical stage, CD4+ cell count, duration of HIV, antiretroviral therapy, and systemic diseases were recorded. All the cases underwent ocular examination as per the study protocol and the findings were noted in a proforma developed for the study. The results were analysed with SPSS 14.0. Of 100 HIV positive cases (including 55 antiretroviral therapy patients) 62% patients were male and 38% were female. The mean age of presentation was 27.72 years. Heterosexual transmission (62%) was the commonest mode of transmission of HIV. Thirty seven percent patients were illiterate. Systemic disease was present in 20% cases. Ocular complaint was present in 53% patients. Ocular disease was present in 40% HIV positive patients. Almost 55% of these cases were on antiretroviral therapy. Moderate to lower CD4 count patient had frequent eye disease. Patients in WHO Stage III and IV also had frequent eye problems. Anterior segment and external ocular disorder was present in 25% patients. The commonest manifestation was conjunctivitis in10% of total cases. Posterior segment manifestation was present in 11%, neuro-ophthalmic lesion in 4% and orbital lesion in 1% patient. Anterior segment manifestation is still common ocular manifestations in HIV positive patients in Nepal. Patients in WHO Stage III and IV are more vulnerable for eye changes. Young aged male and migrant workers are at risk of acquiring HIV in developing country like Nepal. Eye findings even in patientson antiretroviral therapy are similar. However, large sample size and long follow up study is required to have final disclosure.

Neurological manifestations in HIV positive patients attending tertiary care teaching hospital in Western India

Background: Neurologic manifestations affecting the nervous system at all levels and stages of HIV infection are common and increasing with the extended survival of HIV-positive persons. Neurological manifestations occur due to either primary pathologic process of HIV or secondary to opportunistic infection. The neurological manifestations of HIV disease are likely to be different in Indian patients because of prevailing endemic infections, malnutrition, poverty and illiteracy. The present study was conducted to study various neurological manifestations in HIV positive patients presenting to tertiary care teaching institute. Methods: This was observational study of 100 HIV infected patients with clinical evidence of CNS involvement. A detailed clinical history and CNS examination was carried out. CD4 counts were measured and magnetic resonance imaging (MRI), brain/electromyography, nerve conduction studies and cerebrospinal fluid (CSF) examination were done as required for diagnosis. Results were analysed by using percentage and proportions whenever necessary. Results: HIV induced primary illness was present in about 27% cases, while 73% associated with secondary CNS manifestations were mainly due to opportunistic infection. The most common primary illness was distal symmetrical polyneuropathy (17%) followed by myopathy (6%). On the other hand, the most common secondary CNS infection was tuberculous meningitis (TBM; 30%), followed by cryptococcal meningitis (7%), and cerebral toxoplasmosis (4%). The commonest neurological presenting symptoms were headache (38%) whereas the commonest abnormal neurological finding was presence of signs of meningeal irritation (46.5%). The commonest abnormality found on neuroimaging was meningeal enhancement (32%). Conclusions: High index of suspicion of neurological involvement in HIV patients in all stages helps in early diagnosis and timely institution of specific therapeutic treatment which in turn may considerably reduce the morbidity and mortality due to the disease.

Ophthalmic Manifestations in HIV Positive patients and the Indian Perspective

The Eye is a vital sense organ and much like any other organ in the body can be afflicted by HIV. An ophthalmic referral at the time of presentation must be ensured by the treating physician. The ophthalmologist must take utmost care while examining and treating such patients to avoid patient to patient and patient to healthcare provider spread of HIV. A detailed ophthalmic examination for the various manifestations must be done and timely intervention for the same must be carried out which is critical to prevent ocular morbidity. Highly Active Anti Retroviral Therapy (HAART) is safe and has been instrumental in lowering sight threatening complications of HIV such as CMV retinitis.

Neurological manifestations in HIV positive patients in Tehran, Iran

ObjectiveTo evaluate the neurological complications among Iranian HIV-positive patients. MethodsThis cross-sectional study was conducted among 428 patients diagnosed with HIV infection between 2006 and 2009 at Imam Khomeini hospital, Tehran, Iran. Demographic and clinical variables as well as laboratory tests were extracted and analyzed. Also, another 100 patients refereed to Voluntary Counseling and Testing center of the hospital were visited and evaluated for neurological complications. ResultsAmong the patients, neurologic manifestations were observed in 34 (7.94%) patients. Twenty three percent of the patients received antiretroviral therapy. Identified causes included brain toxoplasmosis (14.7%), progressive multi-focal leuko encephalopathy (5.9%), HIV encephalopathy (5.9%), TB meningitis (5%) and unknown etiologies (11.8%). Also, among 100 patients who were admitted and visited at the Voluntary Counseling and Testing center, no one was diagnosed for any neurological manifestations. ConclusionsAccording to our results, toxoplasmosis is the most frequent cause of neurological conditions among Iranian HIV infected patients and should be considered in any HIV/AIDS patient with neurological manifestations.

Mucocutaneous Manifestations of HIV and the Correlation with WHO Clinical Staging in a Tertiary Hospital in Nigeria.

Skin diseases are indicators of HIV/AIDS which correlates with WHO clinical stages. In resource limited environment where CD4 count is not readily available, they can be used in assessing HIV patients. The study aims to determine the mucocutaneous manifestations in HIV positive patients and their correlation with WHO clinical stages. A prospective cross-sectional study of mucocutaneous conditions was done among 215 newly diagnosed HIV patients from June 2008 to May 2012 at adult ART clinic, Wesley Guild Hospital Unit, OAU Teaching Hospitals Complex, Ilesha, Osun State, Nigeria. There were 156 dermatoses with oral/oesophageal/vaginal candidiasis (41.1%), PPE (24.4%), dermatophytic infections (8.9%), and herpes zoster (3.8%) as the most common dermatoses. The proportions of dermatoses were 4.5%, 21.8%, 53.2%, and 20.5% in stages 1–4, respectively. A significant relationship (using Pearson's Chi square with P value <0.05) was obtained between dermatoses and WHO clinical stages. Pearson's correlation coefficient showed a positive correlation between the number of dermatoses and the WHO clinical stages. Dermatoses can therefore serve as diagnostic and prognostic markers in resource limited settings to initiate HAART in clinical stages 3 and 4.

English

BACKGROUND: HIV/AIDS remains one of the world's most significant public health challenges, particularly in lowand middle-income countries.HIV affects the immune system. Its effects are seen in all the systems of the body. These manifestations may be due to HIV infection itself or due to opportunistic infections or malignancies. The clinical and pathologic findings in various organ systems including the pulmonary, skin, gastrointestinal, hematological and nervous systems have been well described in the young adult population. The present study was undertaken to study the presentation of HIV/AIDS infection. OBJECTIVES: 1. To study the clinical profile of HIV positive patients.2. To study about the hematological manifestations in HIV positive patients.3. To study the pattern of opportunistic infections in HIV positive patients. DESIGN: This was a hospital based cross sectional study conductedover a period of 2 years from September 2011 to September 2013.SETTING: ESIC Medical College & Post Graduate Institute Of Medical Science &Research Rajajinagar, Bengaluru. METHODS: This study was conducted in Department of General medicine, ESIC-MC & PGIMSR, Rajajinagar, Bangalore. 100 HIV positive patients were included in the study. RESULTS: In this study, out of 100 HIV positive patients, 62% ofpatients were males and 38% females. 56%patients were in the age group of 31-40 years. 61% of patients presented with fever as main symptom followed by weight loss as the next most common mode of presentation.38% belonged to tuberculosis group (both pulmonary and extra pulmonary) and 68% to the nontuberculosis group. Among the tuberculosis group, 16% of patients had pulmonary tuberculosis (PTB). 8% of the patients had tubercular lymphadenopathy. 10% of patients had abdominal tuberculosis and 4% had tubercular meningitis.60% patients had absolute lymphocyte count (ALC) of 1000/mm3. 46% patients had CD4 count of less than 200/mm3and 54% patients had >200/mm3.CD4 count is significantly correlated with ALC with a P value = 0.023*.CONCLUSION: Majority of HIV positive patients presented with increased incidence of fever, weight loss, chronic diarrhea, cough and oral candidiasis. Most of the adults with HIV presented with AIDS defining illnesses and most of them presented with multiple concurrent opportunistic infections. Categorically most of them presented with WHO stage 3 or stage 4 illnesses.

Pattern of mucocutaneous manifestations in human immunodeficiency virus-positive patients in North India

Mucocutaneous diseases are among the first-recognized clinical manifestations of acquired immune deficiency syndrome. They function as visual markers in assessing the progression of human immunodeficiency virus (HIV) infection. Given the relative ease of examination of skin, its evaluation remains an important tool in the diagnosis of HIV infection. To determine the pattern of mucocutaneous manifestations in HIV-positive patients and to correlate their presence with CD4 counts. This cross-sectional study included 352 HIV-infected patients seen at PGIMER, Chandigarh, India, over a period of 1 year. The patients were screened for mucocutaneous disorders by an experienced dermatologist. The patients were classified into different stages according to the World Health Organization clinical and immunological staging system. The most prevalent infection was candidiasis, seen in 57 patients (16.2%). Prevalence of candidiasis, dermatophytosis, herpes simplex, herpes zoster, molluscum contagiosum (MC), seborrheic dermatitis, adverse drug reaction, nail pigmentation, xerosis and diffuse hair loss differed statistically according to the clinical stages of HIV infection. There was a statistically significant association between immunological stages of HIV infection and dermatophytosis. Results of our study suggest that mucocutaneous findings occur throughout the course of HIV infection. Dermatoses like MC and dermatophytosis show an inverse relation with CD4 cell count, and these dermatoses can be used as a proxy indicator of advanced immunosuppression to start highly active anti-retroviral therapy in the absence of facilities to carry out CD4 cell count.

Pattern of mucocutaneous manifestations in human immunodeficiency virus-positive patients in North India

Background:Mucocutaneous diseases are among the first-recognized clinical manifestations of acquired immune deficiency syndrome. They function as visual markers in assessing the progression of human immunodeficiency virus (HIV) infection. Given the relative ease of examination of skin, its evaluation remains an important tool in the diagnosis of HIV infection.Objective:To determine the pattern of mucocutaneous manifestations in HIV-positive patients and to correlate their presence with CD4 counts.Materials and Methods:This cross-sectional study included 352 HIV-infected patients seen at PGIMER, Chandigarh, India, over a period of 1 year. The patients were screened for mucocutaneous disorders by an experienced dermatologist. The patients were classified into different stages according to the World Health Organization clinical and immunological staging system.Results:The most prevalent infection was candidiasis, seen in 57 patients (16.2%). Prevalence of candidiasis, dermatophytosis, herpes simplex, herpes zoster, molluscum contagiosum (MC), seborrheic dermatitis, adverse drug reaction, nail pigmentation, xerosis and diffuse hair loss differed statistically according to the clinical stages of HIV infection. There was a statistically significant association between immunological stages of HIV infection and dermatophytosis.Conclusion:Results of our study suggest that mucocutaneous findings occur throughout the course of HIV infection. Dermatoses like MC and dermatophytosis show an inverse relation with CD4 cell count, and these dermatoses can be used as a proxy indicator of advanced immunosuppression to start highly active anti-retroviral therapy in the absence of facilities to carry out CD4 cell count.