Skin diseases - clinical indicator of immune status in HIV infection.

摘要

Background Dermatological manifestations are seen at every stage of HIV/AIDS (humanimmunodeficiency virus), and are often the presenting features. These manifestations not onlyact as markers but also reflect the underlying immune status.Objective To establish skin diseases as clinical indicators of underlying immune status in HIVdisease by estimating and correlating with the CD_4, CD_4 : CD_8 ratio.Materials and Methods The CD_4, CD_8, CD_4 : CD_8 ratios were estimated using thefluorescence activated cell sorter (FACS) count system in 20 asymptomatic HIV patients,80 HIV patients with various skin manifestations and 72 healthy volunteers as the controlgroup.Results In comparison with the CD_4 cell count of the control group (mean 885/mm~3, standarddeviation 331), that of the HIV-positive individuals (mean 409.83/mm~3, standard deviation263.07) was statistically correlated with low counts (z= 10.099 and P < 0.05). Similarly therewas statistical significance with the CD_4: CD_8 ratio among these two groups.In comparison with the CD_4 cell count of the asymptomatic HIV-positive individuals (mean 620.65/mm3 and standard deviation 262.065), the CD_4 cell count of the HIV-positive patients with various dermatological manifestations (mean 357.15/mm~3, standard deviation 236.95) was statistically correlated with low counts (z = 4.0978 and P < 0.05). Similarly there was statistical significance with the CD_4: CD_8 ratio among these two groups.Conclusions There was an inverse relation between the CD_4 counts and the incidence and severity of skin diseases in the HIV/AIDS patients. Cutaneous manifestations of HIV can be considered as good clinical indicators to predict and access the underlying immune status in resource-poor countries.