Background: People living with Human Immunodeficiency Virus (PLHIV) are living longer with the advent of highly active antiviral therapy (HAART). Aside from extending the life span, quality of life is vital in PLHIV management. However, there is a paucity of data on the cutaneous manifestations in PLHIV on HAART. The objective of this study is to ascertain the prevalence of cutaneous manifestations, effect on daily lives, and relation to CD4 levels. Methods: This is a prospective cross-sectional study comparing 2 groups of PLHIV patients on HAART and not on HAART therapy done from March 2020 to November 2020. Results: A total of 259 patients were recruited in this study with a mean age of 40 years. There were 216 (83.4%) male and 43 (16.6 %) female. Men having sex with men accounts for 49%. The most common cutaneous disorder was post-inflammatory pigmentation (20.4%). Infective dermatoses were 43 (6.7%), and cutaneous malignancy 3 (0.6%). Mean DLQI in PLHIV on HAART were 2, as compared to PLHIV not on HAART which scored 3. Bidayuh ethnicity accounts for 30% of adverse drug reactions with Bactrim being the most common drug. Conclusion There is a high prevalence of dermatoses in PLHIV. HAART increases the CD4 count of patients thereby reducing the risk of opportunistic infection and related disorders. However, it did not reduce the cutaneous manifestations in PLHIV, as HAART itself may increase the risk of adverse cutaneous drug reactions. DLQI is not the best tool to assess quality of life.
HIV ; Dermatomycoses--pathology

Aspergillosis ; drug therapy ; etiology ; pathology ; Aspergillus flavus ; isolation & purification ; Dermatomycoses ; drug therapy ; etiology ; pathology ; Female ; Humans ; Middle Aged ; Skin Ulcer ; etiology

Penicillium marneffei may cause life-threatening systemic fungal infection in immune-compromised patients and it is endemic in Southeast Asia. A 39-yr-old HIV-infected male, living in Laos, presented with fever, cough, and facial vesiculopapular lesions, which had been apparent for two weeks. CT scans showed bilateral micronodules on both lungs; Pneumocystis jirovecii was identified by bronchoscopic biopsy. Despite trimethoprim-sulfamethoxazole and anti-tuberculosis medications, the lung lesions progressed and the facial lesions revealed central umbilications. Biopsy of the skin lesions confirmed disseminated penicilliosis, with the culture showing P. marneffei hyphae and spores. The P. marneffei was identified by rRNA PCR. A review of the bronchoscopic biopsy indicated penicilliosis. The patient completely recovered after being prescribed amphotericin-B and receiving antiretroviral therapy. This is the first case of penicilliosis in a Korean HIV-infected patient. It is necessary to consider P. marneffei when immunocompromised patients, with a history of visits to endemic areas, reveal respiratory disease.
Adult ; Amphotericin B/therapeutic use ; Anti-HIV Agents/therapeutic use ; Antifungal Agents/therapeutic use ; Bronchoscopy ; Dermatomycoses/drug therapy/microbiology/pathology ; HIV Infections/*diagnosis/drug therapy ; Humans ; Immunocompromised Host ; Laos ; Lung Diseases/drug therapy/*microbiology ; Male ; Penicillium/genetics/*isolation & purification ; Pneumocystis jirovecii/isolation & purification ; Tomography, X-Ray Computed