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ABSTRACT
Introduction: Studies concerning the prevalence of HIV/AIDS related skin diseases in Ethiopia are limited. Skin is one of the organs that can be early affected by HIV infection. Some skin diseases are an indicator of HIV - infection.
Objective of the study: to identify the prevalence of the most commonly
encountered skin diseases among HIV/AIDS patients, and to investigate their association with CD4 lymphocyte count.
Material and Method: 218 randomly selected HIV - positive patients were investigated for skin and mucous membrane lesions from May 2006 to July 2006 at Armed Forces Teaching Hospital ART clinic. The following information was collected: patient’s age, sex, marital status and every patient was asked how long they consider themselves sick in general. Staging of the disease was made depending on the clinical signs and symptoms based on WHO staging. All patients were investigated by one dermatologist.
Result: during the study period, out of 218 cases 185 (84%) had dermatological diseases, and 35 (16%) were free of any skin diseases.
The patterns of skin diseases were analyzed and compared with the CD4 count.
Fungal infections 28%, viral infections 14.7%, seborrhoec dermatitis 10.5%, photodermatitis and disorders of pigmentation 8.3%, allergic dermatosis and drug reactions 6.6%, pruritic papular eruption 5% were the predominating diseases.
Disorders of the nail and hair 4.8%, xerosis and acquired ichthyosis 3.5%, bacterial skin infections 3.4%, oral hairy leukoplakia 1%, psoriasis 0.7%, tuberculosis of the skin 0.5%
We tried to see the association of CD4 count with clinical staging based on WHO guideline. The result showed that 132 (60.5%) patients were with CD4 less than 200 cells and they were all classified as stage 3 and 4. 74 (34%) had CD4 between 200 – 500, out of which 33 (44.6%) were stage 1and 2, and 41 (55.4%) were stage 3 and 4. 12 (5.5%) had CD4 count of more than 500 and they were classified as stage 1 an2.
All participant were asked how long they consider themselves sick, and 23 (10.5%) considered themselves healthy, 67 (30.7%) think themselves sick for 1 year, 52 (23.85%) had ill health for 2 years, 43 (19.7%) were sick for 3 years, and 33 (15.2%) considered themselves for more than 4 years ranging up to 11 years.
Analysis of the marital status showed that 19 (6.7%) were widowed, 80 (36.7%) were single, 117 (53.7%) were married and 2 (0.9%) were divorced.
Conclusion: As it has been reported by different investigators fungal, viral infections and seborroec dermatitis are the earliest and commonest skin manifestations of HIV infection. The positive association clinical disease staging based on WHO staging guideline with CD4 count may help to start ART treatment in resource poor countries where CD4 counter is not available. The high percentage of (53.7%) married population being infected shows that the military and its family, which lives a separate life for a long time, are at high risk for the exposure of the virus. |
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