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Relationship between CD4 levels and mucocutaneous manifestations in HIV-AIDS patients at Dr. Soetomo General Academic Teaching Hospital, Surabaya, Indonesia

Background: CD4 can assess the immune status of a patient with HIV, and this is considered the standard way of assessing and characterizing the severity of HIV-related immunodeficiency. CD4 cell counts are associated with increased mucocutaneous manifestations. This study aims to explain the relationship between CD4 and mucocutaneous manifestations in HIV-AIDS   patients. 
Methods: This study is analytical with a retrospective cross-sectional design. The data of the present study was obtained from a number of 614 HIV-AIDS patients with mucocutaneous manifestations, but only 149 patients met the inclusion criteria, including the CD4 level data. 
Results: The majority of the patients in this study were male (74.5%), which includes patients under the age group of 25-49 years (70.5%). The most common risk factor was heterosexuality (48.3%). Most CD4 levels were in the CD4 group < 200 (64.4%). Based on the distribution of mucocutaneous manifestations, the various cases were reported as infections (55.8%). Pyoderma and syphilis were significantly associated with CD4 counts ≥ 200 cells/mm3 with a risk of 3.7 and 7.8 times than CD4 cells < 200 cells / mm3. On the other hand, candidiasis was higher in CD4 count < 200 cells/mm3 with a significant difference and a risk of 0.3 times compared to CD4 count ≥ 200 cells/mm3. 
Conclusion: Several mucocutaneous manifestations can be considered predictors of advanced immunosuppression (low CD4 level), which were pyoderma, syphilis, and candidiasis in this study.