Josephine Mbuagbaw, Issac Eyong, George Alemnji, Ngole Mpoudi, Albert Same-Ekobo
Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Cameroon.
Int J Dermatol. 2006 Mar;45(3):280-4. doi: 10.1111/j.1365-4632.2004.02529.x.
Skin manifestations are common clinical features among HIV/AIDS-positive patients. Their frequencies, patterns and associated factors have been shown to vary from region to region. The present study is aimed at documenting skin manifestations and their relationships with CD4 cell counts among HIV/AIDS patients in Cameroon.
This study lasted for 16 months (from September 2001 to December 2002). After informed consent, data on skin disorders, HIV status, CD4 and viral load were obtained by physical examination and laboratory methods.
Of the 384 subjects studied, 236 (61.5%) were females and 148 (38.5%) were males. Up to 264 (68.8%) patients presented with at least one type of skin problem. Generalized prurigo, oral candidiasis, herpes zoster, and vaginal candidiasis were the most common skin problems. Mean CD4 cell count (128 +/- 85 cells/mm(3)) and mean viral load (79,433 copies/mL) in patients with herpes zoster were higher (P < 0.001). Patients with oral candidiasis and vaginal candidiasis had significantly lower (109 +/- 127 cells/mm(3), P < 0.02) and higher (131 +/- 85 cells/mm(3), P < 0.05) mean CD4 cell counts, respectively. Prurigo was associated with higher mean viral load (31,623 +/- 20 copies/mL, P < 0.04). Viral lesions were associated with high mean CD4 cell count (123 +/- 83 cells/mm(3), P < 0.001). Kaposi's sarcoma and parasitic lesions (crusted scabies) were both, respectively, associated with lower mean CD4 cell counts [(78 +/- 66 cells/mm(3), P < 0.001) (6 +/- 0 cells/mm(3), P < 0.04)].
We conclude, first that skin problems are common in HIV-infected individuals in Cameroon and that patients with advanced stages of these problems have relatively very low mean CD4 cell counts. Second, that mucocutaneous disorders like vaginal candidiasis and herpes zoster occur early in HIV infection while Kaposi's sarcoma is common in advanced HIV infection.
皮肤表现是艾滋病毒/艾滋病阳性患者常见的临床特征。其发生率、模式及相关因素因地区而异。本研究旨在记录喀麦隆艾滋病毒/艾滋病患者的皮肤表现及其与CD4细胞计数的关系。
本研究持续了16个月（从2001年9月至2002年12月）。在获得知情同意后，通过体格检查和实验室方法获取有关皮肤疾病、艾滋病毒感染状况、CD4和病毒载量的数据。
在研究的384名受试者中，236名（61.5%）为女性，148名（38.5%）为男性。多达264名（68.8%）患者出现至少一种皮肤问题。泛发性痒疹、口腔念珠菌病、带状疱疹和阴道念珠菌病是最常见的皮肤问题。带状疱疹患者的平均CD4细胞计数（128±85个细胞/mm³）和平均病毒载量（79,433拷贝/mL）较高（P<0.001）。口腔念珠菌病和阴道念珠菌病患者的平均CD4细胞计数分别显著较低（109±127个细胞/mm³，P<0.02）和较高（131±85个细胞/mm³，P<0.05）。痒疹与较高的平均病毒载量相关（31,623±20拷贝/mL, P<0.04）。病毒感染性病变与较高的平均CD4细胞计数相关（123±83个细胞/mm³，P<0.001）。卡波西肉瘤和寄生虫性病变（结痂性疥疮）均分别与较低的平均CD4细胞计数相关[（78±66个细胞/mm³，P<0.001）（6±0个细胞/mm³，P<0.04）]。
我们得出以下结论，首先，喀麦隆艾滋病毒感染者中皮肤问题很常见，且这些问题处于晚期的患者平均CD4细胞计数相对非常低。其次，阴道念珠菌病和带状疱疹等皮肤黏膜疾病在艾滋病毒感染早期出现，而卡波西肉瘤在艾滋病毒感染晚期常见。
