Prevalence and Types of Mucocutaneous Disorders, Their Correlation  to CD4 Count and Their Impact on Quality of Life in Adults with HIV  Infection

Yee Ting Lim; Kwee Eng Tey; Siew Eng Choon

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Prevalence and Types of Mucocutaneous Disorders, Their Correlation to CD4 Count and Their Impact on Quality of Life in Adults with HIV Infection

Author: Yee Ting Lim ¹ ; Kwee Eng Tey ¹ ; Siew Eng Choon ²
Author Information

1. Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
2. Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Healthy Sciences, Monash University Malaysia, Johor Bahru, Johor, Malaysia
Publication Type:Journal Article
Keywords: Mucocutaneous manifestations; Human immunodeficiency virus infection; CD4+ T-cell counts; Quality of life
MeSH: HIV Infections; Mucocutaneous Lymph Node Syndrome
From:Malaysian Journal of Dermatology 2021;46(June 2021):11-20
CountryMalaysia
Language:English
Abstract: Background:Data on prevalence and type of mucocutaneous diseases in HIV-positive patients and their impact on quality of life (QoL) are sparse. We aim to determine prevalence and type of mucocutaneous disorders, their correlation to CD4+ counts and impact on QoL for adults with HIV, using the Dermatology Life Quality Index (DLQI).
Methods:A cross-sectional study of HIV-infected adults seen in HIV and Dermatology Clinic.
Results:The majority (90%) of 174 participants recruited was male. Median age at diagnosis of HIV infection was 29 years (IQR 10). Mucocutaneous disorders were present in 90.2%, out of which 58.6% had two or more mucocutaneous disorders. Mean CD4+ count was significantly lower in patients with, compared to those without mucocutaneous disorders (363 vs 548 cells/µL; p=0.030). Infections accounted for 67.2% of all mucocutaneous disorders seen, followed by inflammatory dermatoses (51.7%), cutaneous adverse drug reactions (17.8%) and neoplasm (2.3%). The five most frequent manifestations were eczema (22.4%), anogenital warts (21.2%), candidiasis (16.7%), dermatophytosis (15.5%) and secondary syphilis (12.0%). Oral candidiasis, pruritic papular eruption, drug-induced maculopapular eruption and drug rash with eosinophilia and systemic symptoms were significantly more prevalent in patients with CD4+ counts <200 cells/µL but anogenital warts were more prevalent in patients with CD4+ counts ≥200 cells/µL. The mean DLQI score was 8.39 (SD ± 6.83). QoL was severely impaired (DLQI >10) in 34.4%.
Conclusion:Mucocutaneous disorders were common in HIV patients causing significant impairment in quality of life. Prevalence co-related with low CD4+ counts. Adequate management of HIV may reduce the prevalence of mucocutaneous disorders and improve QoL.
Full text:15.2021my0002.pdf