Mucocutaneous manifestation of pediatric human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in relation to degree of immunosuppression: A study of a West African population

摘要

Background: Mucocutaneous lesions occur at one point or the other during the course of human immunodeficiency virus (HIV) disease. These lesions can be the initial presenting features but could also be a pointer to the presence of immunosuppression. Aim and objectives: This study was carried out to determine the pattern of mucocutaneous manifestation in children who have human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in relation to their level of immunosuppression. Methods: One hundred children who were HIV seropositive aged 18months to 16years were evaluated for mucocutaneous lesions, and their degree of immunosuppression was also determined using total CD 4+ count or CD 4+ percentage. Another group of age and gender matched 100 HIV-negative children were also examined for mucocutaneous lesions. Results: The mucocutaneous manifestations were more common among the subjects compared to controls (P=0.000). The overall prevalence among the seropositive and seronegative subjects was 64% and 12% respectively. The prevalence of mucocutaneous findings in children with severe, moderate, and no immunosuppression were 93.8%, 55.2%, and 46.2%, respectively. The lesions were significantly more common among those with moderate and severe immunosuppression compared to those with no immunosuppression (P=0.000). Multiple lesions were more frequent among those with severe immunosuppression. Oral thrush was the most frequent lesion (25.6%) among the subjects followed by pruritic papular eruption (20.7%) and dermatophytosis (14.1%). Severe and atypical forms of dermatophytosis and herpes ulcer were also observed among the subjects. Conclusion: This study shows that mucocutaneous lesions are common in children with HIV/AIDS and could be an early indicator of immune suppression. It is important to recognize them early in order to enhance early case detection and treatment.