Basida Sanket D, Basida Brinda, Zalavadiya Nirav, Trivedi Arti P
Department of Internal Medicine, Pandit Deendayal Upadhyay Medical College, Rajkot, IND.
Department of Internal Medicine, Detroit Medical Center Sinai-Grace Hospital, Detroit, USA.
Cureus. 2021 Aug 3;13(8):e16852. doi: 10.7759/cureus.16852. eCollection 2021 Aug.
Background and objective In developing countries, the dermatological manifestation of the human immunodeficiency virus (HIV) has a high prevalence. Apart from the systemic infection that ensues HIV, skin manifestations form a major part of the disease burden. They can present with atypical forms, and necessary tools for diagnosis may not be available in rural and remote parts of the country. Hence, they can stay misdiagnosed or undiagnosed, contributing to the morbidity of the patients. We attempted to enumerate the dermatologic opportunistic infections (OIs) in Rajkot city, Gujarat, India, in order to disseminate knowledge regarding the same. Material and methods It is a retrospective observational study. A total of 253 patients under treatment for HIV/acquired immunodeficiency syndrome (AIDS) at the ART Center (anti-retroviral therapy center) from 2011 to 2019 were included. The data recorded in the registry during the above-mentioned period were utilized in the study. The diagnoses of OIs were made clinically by multiple health care providers experienced in the field. Result Two hundred twenty-seven (227) of 253 (89.72%) of the patients had some form of dermatologic OI during the course of their treatment. Overall, fungal infections (33.03%) were most common, followed by bacterial infections (28.18%) and viral (14.55%) infections. Among the non-infectious causes, cheilitis/angular stomatitis topped the list. Among the STDs, herpes was the most common skin manifestation seen with a 10.57% prevalence. The CD4+ cell count for fungal infection ranged from 353-467 and was seen in stage 2 of the disease course. Bacterial infections were seen mainly during the early and middle stages of the disease while viral infections were most prevalent in stage 2 of the disease. Conclusion Skin manifestations can be useful clinical predictors of the disease stage, especially in resource-limited settings and in developing countries. They can present with unusual and atypical forms. Hence, knowledge about the prevalence of these OIs in a particular geographical area can be very useful for physicians in treating them and decreasing the disease burden.
背景与目的 在发展中国家，人类免疫缺陷病毒（HIV）的皮肤表现十分常见。除了HIV引发的全身感染外，皮肤表现构成了疾病负担的主要部分。这些皮肤表现可能呈现非典型形式，而在该国农村和偏远地区可能没有必要的诊断工具。因此，它们可能会被误诊或漏诊，从而增加患者的发病率。我们试图统计印度古吉拉特邦拉杰果德市的皮肤机会性感染（OIs）情况，以便传播相关知识。
材料与方法 这是一项回顾性观察研究。纳入了2011年至2019年期间在抗逆转录病毒治疗中心（ART中心）接受HIV/获得性免疫缺陷综合征（AIDS）治疗的253名患者。研究使用了上述期间登记册中记录的数据。OIs的诊断由该领域经验丰富的多名医疗保健提供者通过临床诊断得出。
结果 253名患者中有227名（89.72%）在治疗过程中出现了某种形式的皮肤机会性感染。总体而言，真菌感染（33.03%）最为常见，其次是细菌感染（28.18%）和病毒感染（14.55%）。在非感染性病因中，唇炎/口角炎位居榜首。在性传播疾病中，疱疹是最常见的皮肤表现，患病率为10.57%。真菌感染的CD4 + 细胞计数范围为353 - 467，出现在病程的第2阶段。细菌感染主要出现在疾病的早期和中期，而病毒感染在疾病的第2阶段最为普遍。
结论 皮肤表现可能是疾病阶段的有用临床预测指标，尤其是在资源有限的环境和发展中国家。它们可能呈现不寻常和非典型的形式。因此，了解这些机会性感染在特定地理区域中的患病率对于医生治疗它们并减轻疾病负担非常有用。
