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Dermatological Manifestations of HIV/AIDS Patients in the Era of HAART: Report from an ART Center of Chattogram

Introduction: Skin diseases are common striking features of HIV/AIDS patients and may vary considerably due to ethnic and geographic regions and currently by the influence of HAART also. However, there is a dearth of information in Bangladeshregarding the dermatological manifestations in HIV/AIDS patients. The purpose of this study is to find out the spectrum of cutaneous disorders in HIV/AIDS patients in the era of HAART.

Materials and Methods: A descriptive cross-sectional study has been carried out to find the targeted results in the Chittagong Medical College Hospital, Bangladesh between the periods 2017 and 2020.

Results: Of the 40 patients with HIV/AIDS, 22 (55%) were males and 18 (45%) were females. The age of the patients ranged from 8 to 60 years with mean age 38 (±0.966 SD) years. The age-specific cumulative HIV/AIDS cases at 31-40 years were high 19 (47.5%) among all age groups. The majority of the patients were migrant worker 22 (55%) with low socio-economic 32 (80%) background and common transmission mode was heterosexual 36 (90%). Most of the patients 32 (80%) had mucocutaneous disorders and Infective dermatoses accounted 30 (75%) and the non-infective inflammatory dermatoses were 21 (52.5%). Eight (20%) patients presented with 3 or more skin disorders. Common infective dermatoses were fungal infections 15 (37.5%) followed by viral infections 8 (20%), bacterial infections 4 (10%) and scabies 3 (7.5%). Common non-infective dermatoses were generalized pruritus 6 (15%) followed by prurigo simplex 4 (10%), psoriasis 4 (10%), eczema 3 (7.5%), pruritic papular eruption 1 (2.5%), seborrhoeic dermatitis 1 (2.5%), urticaria 1 (2.5%) and xerosis 1 (2.5%).Patients treated with HAART had decreased rates of oral candidiasis, herpes simplex, but increased rates of drug reactions 19 (47.5%). The most common drug eruption following HAART is morbiliform rash 11 (27.5%) and the commonest offending agent is nevirapine. The prevalence of mucocutaneous disorders were higher in patients with CD4 <200 cells/mm3.

Conclusions: A wide range of skin disorders (80%) is observed in Bangladeshi HIV/AIDS patients and HAART had an impact on the spectrum of HIV/AIDS associated mucocutaneous disorders. They are seen at every stage of HIV/AIDS and are often the initial presentation in most instances within our environment. There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of HIV/AIDS patients.