Prevalence of mucocutaneous manifestations in human immunodeficiency infection - learning from a rural centre in Tamilnadu, India

Background: Ever since its recognition in 1981, HIV continues to ravage all the continents of the world.  HIV infection produces a panorama of mucocutaneous manifestations ranging from the macular rash seen in acute ‘sero conversion’ syndrome to extensive end-stage Kaposi’s sarcoma. Skin disease may be the first presenting feature of the disease and it raises the suspicion to screen for HIV infection. Disease progression may result in significant morbidity.Methods: This study   was undertaken in 116 People living with HIV, who attended the well health clinic in Department of Skin and STD, IRT Perundurai Medical College, Erode, in rural Tamilnadu, from 15th June 2005 to 14th August 2005.  The study patients were interviewed   after pre and post-test counselling. All the patients underwent a complete physical and genital examination with keen clinical analysis for the mucocutaneous manifestations of HIV infection.Results:   96% of HIV positives in our study had mucocutaneous manifestations. Commonest disease observed was oral candidiasis n=63 (56.25%). Dermatophytosis n=46 (41.07%) was the second most common infection followed by papular and follicular eruptions in HIV (n=34, 30.3%).Conclusions: Respiratory system illnesses were the commonest presenting opportunistic illnesses followed by the gastrointestinal tract

Dermatological manifestations in PLHIV visiting link ART centre at rural medical college hospital in Western Tamilnadu, India

Background: Ever since the early reports of human immuno deficiency infection, it presented as wide range of infectious and non-infectious dermatoses which correlate with the degree of immunodeficiency. Skin assessment remains a vital tool in the diagnosis and management of HIV infection due to relative easiness of examination. Most of skin diseases are amenable to diagnosis by inspection and biopsy. In this descriptive study, we have enumerated in detail the dermatological manifestations of Link ART centre clients.Methods: To analyze the dermatological manifestations in people living with HIV, we undertook a prospective observational study of all PLHIV on ART visiting IRT Perundurai Medical College Hospital link anti- retroviral therapy centre (LAC) during July 2015 to August 2016 with focus to skin manifestations.Results: Among the 140 clients, 22 in 2010, 12 in 2011, 6 in 2012, 51 in 2013, 36 in 2014, and 9 in 2015, 3 up to June 2016 enrolled for follow up. 31 were transferred to nearby ART, Link ART centres during this period as per their request, 4 lost for follow up and 6 deceased after enrolment, finally ninety-nine (39 male; 60 female) were utilizing our centre during the study period. Majority of participants were on ZLN (zidovudine, lamivudine, and nevirapine) regimen, hailing from rural zones, belonged to low or low middle income group, were undertaking farming, cattle rearing. CD4 counts of the asymptomatic clients in the ZLN group noted increase and decrease in the ZLE (zidovudine, lamivudine, and efavirenz), TLN (tenofovir, lamivudine, and nevirapine) group.  In the symptomatic clients, decline in the individual and the mean counts except in female ZLN subset. 70% were clinically asymptomatic and 30 % were having some dermatological manifestations. Multiple manifestations were seen in 5 clients during the study period. Dermatological manifestations observed commonly were fungal and viral infections, xerosis/ichthyoses, adverse drug reactions like lipodystrophy, and discoloration of nails.Conclusions: Skin manifestations observed in this study were due to aging and long term cosmetic side effects of highly active antiretroviral therapy  (HAART). Lipodystrophy posed significant aesthetic distress in HAART clients. Hence, early management would decrease the most offending cosmetolgical side effects of the disease and drugs. Therapy yields the declining trend in the inflammatory, infectious dermatoses

Prevalence of mucocutaneous manifestations in human immunodeficiency infection - learning from a rural centre in Tamilnadu, India

Background: Ever since its recognition in 1981, HIV continues to ravage all the continents of the world.  HIV infection produces a panorama of mucocutaneous manifestations ranging from the macular rash seen in acute ‘sero conversion’ syndrome to extensive end-stage Kaposi’s sarcoma. Skin disease may be the first presenting feature of the disease and it raises the suspicion to screen for HIV infection. Disease progression may result in significant morbidity.Methods: This study   was undertaken in 116 People living with HIV, who attended the well health clinic in Department of Skin and STD, IRT Perundurai Medical College, Erode, in rural Tamilnadu, from 15th June 2005 to 14th August 2005.  The study patients were interviewed   after pre and post-test counselling. All the patients underwent a complete physical and genital examination with keen clinical analysis for the mucocutaneous manifestations of HIV infection.Results:   96% of HIV positives in our study had mucocutaneous manifestations. Commonest disease observed was oral candidiasis n=63 (56.25%). Dermatophytosis n=46 (41.07%) was the second most common infection followed by papular and follicular eruptions in HIV (n=34, 30.3%).Conclusions: Respiratory system illnesses were the commonest presenting opportunistic illnesses followed by the gastrointestinal tract