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Fulltext Toxoplasmosis in HIV/AIDS: a living legacy

Nissapatorn V

Southeast Asian J. Trop. Med. Public Health, 2009 Nov;40(6):1158-78.
PMID: 20578449

Toxoplasmosis has historically been considered one of the most important opportunistic infections detected in HIV/AIDS patients. The prevalence rates of latent Toxoplasma infections in HIV-infected patients has been found to vary greatly from 3% to 97%. Prevalence has been found to be related to ethnicity, certain risk factors, and reactivation of toxoplasmosis. Prior to antiretroviral therapy, toxoplasmic encephalitis (TE) was the most common focal cerebral lesion detected in AIDS patients with Toxoplasma infection, occurring in approximately half of Toxoplasma-seropositive patients. Other forms of dissemination have also been reported in AIDS patients in sites such as the eyes, lungs, heart and spinal cord. Anti-Toxoplasma therapy and chemoprophylaxis have shown effectiveness in reducing the incidence of TE, while noncompliance has been identified as a cause of relapse in these settings. Toxoplasmosis is one of the most common neuropathological complications found at autopsy. Rapid progress in the development of highly active antiretroviral therapy (HAART) has changed the observed patterns with TE, for which there has been a marked decrease in overall incidence. Subsequently, TE has been found to be significantly associated with the so-called "neurological immune restoration inflammatory syndrome" (NIRIS). Toxoplasma screening programs are recommended for all newly diagnosed HIV-positive patients. Chemoprophylaxis should be considered in HIV-infected patients who have a CD4 < 200 cells/mm3, particularly in settings where resources are limited and there is not access to HAART. TE remains a cause of morbidity and mortality among AIDS patients.

Matched MeSH terms: AIDS-Related Opportunistic Infections/immunology; AIDS-Related Opportunistic Infections/epidemiology*; AIDS-Related Opportunistic Infections/parasitology*; AIDS-Related Opportunistic Infections/prevention & control
Fulltext Opportunistic infection associated to HIV/AIDS in Nepal

Arijit G, Shalini C

Med J Malaysia, 2007 Mar;62(1):88.
PMID: 17682586

Nepal is a low prevalence country for HIV/AIDS but has progressed into the category of a "concentrated" epidemic. The epidemic remains concentrated in a few vulnerable populations, namely Female Sex Workers and their clients, Intravenous Drug Users and Seasonal Migrant Workers. There is a big difference between estimated and reported cases for HIV, >60000 and almost 5000 respectively1 . There might be many more undiagnosed cases. Mother–to–child transmission is the largest source of HIV infection in children in Nepal so far.

Matched MeSH terms: AIDS-Related Opportunistic Infections/etiology; AIDS-Related Opportunistic Infections/mortality; AIDS-Related Opportunistic Infections/epidemiology*
Fulltext Disseminated histoplasmosis in AIDS: a report of three patients

Tan HJ, Cheong I, Muhaizan WM

Med J Malaysia, 2000 Jun;55(2):259-62.
PMID: 19839156

Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. Although uncommon, it should be considered among the list of important opportunistic infections in severely immunocompromised patients. Patients living with AIDS are at particular risk of disseminated histoplasmosis. Diagnosis requires a high level of clinical suspicion. The infection is best confirmed by demonstration of the organism in tissue specimens or by culture. Amphotericin B is the most effective drug for severe disseminated histoplasmosis. Response is good but life-long maintenance is required to prevent relapse.

Matched MeSH terms: AIDS-Related Opportunistic Infections*
Salmonellosis in persons infected with human immunodeficiency virus: a report of seven cases from Malaysia

Puthucheary SD, Ng KP, Hafeez A, Raja NS, Hassan HH

Southeast Asian J. Trop. Med. Public Health, 2004 Jun;35(2):361-5.
PMID: 15691137

Persons infected with human immunodeficiency virus (HIV) have an increased risk of salmonellosis when compared to the general population. We describe seven such patients with Salmonella bacteremia, of whom two had recurrent salmonellosis. In the latter two cases the infection was unusually severe, characterized by widespread infection, bacteremia and relapse, despite standard antimicrobial therapy. HIV-infected individuals will benefit from education on the source of Salmonella, mode of acquisition and prevention through safe food handling and food preparation practices. Because of the difficulty of eradicating Salmonella infection in patients with acquired immunodeficiency syndrome, long-term suppressive treatment with antimicrobials is warranted.

Matched MeSH terms: AIDS-Related Opportunistic Infections/diagnosis*; AIDS-Related Opportunistic Infections/immunology; AIDS-Related Opportunistic Infections/microbiology
Disseminated Penicillium marneffei infection: a report of five cases in Singapore

Kurup A, Leo YS, Tan AL, Wong SY

Ann Acad Med Singap, 1999 Jul;28(4):605-9.
PMID: 10561784

Penicillium marneffei has emerged as an important opportunistic pathogen in HIV-infected patients in Southeast Asia. We report the first 5 cases of P. marneffei diagnosed in Singapore. All the patients were HIV-infected and were either Thai nationals or had frequently travelled to Thailand. Fever, weight loss, anaemia and papular skin lesions were common clinical manifestations in our patients, all of whom had the organism isolated from blood. Skin biopsy specimens showed histological evidence of P. marneffei in 2 patients. In 1 patient each, the organism grew in cultures of specimens from bone marrow and respiratory secretions. Amphotericin B therapy followed by itraconazole were used in 3 of our 5 patients and was associated with good clinical response and outcome.

Matched MeSH terms: AIDS-Related Opportunistic Infections/diagnosis*; AIDS-Related Opportunistic Infections/ethnology; AIDS-Related Opportunistic Infections/microbiology
Fulltext CNS toxoplasmosis presenting with obstructive hydrocephalus in patients of retroviral disease--a case series

Basavaprabhu A, Mahalingam S, Deepak M, Satish R

Med J Malaysia, 2012 Apr;67(2):214-6.
PMID: 22822648

CNS toxoplasmosis presenting as hydrocephalus is a very rare entity. We present three cases of HIV positive patients whose brain imaging revealed hydrocephalus and who improved with anti toxoplasma medication along with intravenous steroids and did not require any CSF shunting procedures. The mechanism of hydrocephalus in CNS toxoplasmosis is usually due to compression of CSF outflow pathway by ring enhancing lesions but even in their absence hydrocephalus can be rarely seen due to ventriculitis. Hence in HIV positive patients with unexplained hydrocephalus CNS toxoplasmosis should be considered and such patients if started on treatment early have a good prognosis without requiring neurosurgical intervention.

Matched MeSH terms: AIDS-Related Opportunistic Infections/diagnosis*; AIDS-Related Opportunistic Infections/drug therapy
Pneumocystis pneumonia among HIV patients in Malaysia

Asmal HS, Mustafa M, Abdullah S, Zaidah AR, Nurhaslindawati AR, Sarimah A, et al.

Southeast Asian J. Trop. Med. Public Health, 2009 Nov;40(6):1293-7.
PMID: 20578464

Pneumocystis pneumonia (PCP) has become the most common opportunistic infection in HIV/AIDS patients with a CD4 count < or = 200. The incidence of PCP has declined as a result of prophylaxis and better highly active antiretroviral therapy (HAART). The objective of this study was to review the demographic data of HIV patients diagnosed clinically as having PCP at the Hospital Raja Perempuan Zainab II (HRPZ II) in Malaysia. This was a prospective study. All HIV patients admitted to HRPZ II with respiratory symptoms were enrolled in this study after giving informed consent. Their demographic data were collected. The total number of HIV patients reviewed in this study was 107. Nearly 60% of patients were clinically diagnosed as having pneumocystis pneumonia based on their signs, symptoms and chest x-ray findings. A CD4 count was available in 83 out of 107 patients. The fifty-three percent of patients(44) had a CD4 < 200 and were clinically diagnosed as having pneumocystis pneumonia. Thirty percent had a CD4 < 200 but did not have clinical pneumocystis pneumonia. Sixteen point nine percent had a CD4 > 200 and had clinical pneumocystis pneumonia, three of whom had received HAART, four patients had received prophylaxis. Overall, 94 patients (87.8%) received prophylaxis for pneumocystis pneumonia. Thirty-three patients (30.8%) received HAART. The occurrence of pneumocystis pneumonia was common before full implementation of HAART. Pneumocystis pneumonia can occur in patients with a CD4 >200.

Matched MeSH terms: AIDS-Related Opportunistic Infections/epidemiology*; AIDS-Related Opportunistic Infections/prevention & control
Fulltext Tuberculosis in Malaysia: combating the old nemesis

Aziah AM

Med J Malaysia, 2004 Mar;59(1):1-3.
PMID: 15535327 MyJurnal
Matched MeSH terms: AIDS-Related Opportunistic Infections/epidemiology; AIDS-Related Opportunistic Infections/prevention & control
Fulltext Human isosporiasis in an AIDS patient--report of first case in Malaysia

Shekhar KC, Ng KP, Rokiah I

Med J Malaysia, 1993 Sep;48(3):355-60.
PMID: 8183153

An AIDS patient with multiple opportunistic infections (Candida, Pneumocystis carinii and Isospora belli) was identified at the University Hospital, Kuala Lumpur. The patient presented with profuse diarrhoea associated with lethargy, anorexia and weight loss. Routine stool examination showed Isospora belli oocysts. The infection responded to treatment with trimethroprim-sulfamethoxazole but relapse occurred 8 weeks later. This represents the first documented case of isosporiasis to occur in an AIDS patient in Malaysia.

Matched MeSH terms: AIDS-Related Opportunistic Infections/drug therapy; AIDS-Related Opportunistic Infections/etiology*
Penicillium marneffei infection in an African man

Yap FB, Thevarajah S, Asmah J

Dermatol. Online J., 2010;16(7):2.
PMID: 20673530

Penicilliosis is a systemic fungal infection caused by Penicillium marneffei. The infection is most commonly seen in Southeast Asia, Southern China, Hong Kong, and Taiwan. It is rarely seen among individuals of African descent. Here, we report a case of penicilliosis in an African man from Namibia who was studying in Malaysia. He presented with multiple umbilicated papules associated with cough, fever, loss of appetite, and weight. He also had urethral discharge and admitted to unprotected sexual intercourse with multiple partners. Histopathological examination of a skin papule showed the presence of multiple 2 to 4 microm intracellular yeast cells. Culture of the papule revealed Penicillium marneffei. The serology for human immunodeficiency virus (HIV) was positive. This case illustrates the need to recognize penicilliosis in any individuals staying or travelling to Southeast Asia and the need to look for underlying HIV infection in adults with umbilicated papules.

Matched MeSH terms: AIDS-Related Opportunistic Infections/diagnosis*; AIDS-Related Opportunistic Infections/drug therapy; AIDS-Related Opportunistic Infections/microbiology; AIDS-Related Opportunistic Infections/pathology
Isoniazid preventive therapy in correctional facilities: a systematic review

Al-Darraji HA, Kamarulzaman A, Altice FL

Int J Tuberc Lung Dis, 2012 Jul;16(7):871-9.
PMID: 22410101 DOI: 10.5588/ijtld.11.0447

Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide and the main cause of death in correctional facilities in middle- and low-income countries. Due to the closed environment and the concentration of individuals with TB-related risk factors, effective measures are required to control TB in such settings. Isoniazid preventive therapy (IPT) represents an effective and cost-effective measure. Despite international recommendations that IPT be integral to TB control, it is seldom deployed. A systematic review of interventions used to assess IPT initiation and completion in correctional facilities was conducted using published studies from two biomedical databases and relevant keywords. Additional references were reviewed, resulting in 18 eligible studies. Most (72%) studies were conducted in the United States and in jail settings (60%), with the main objective of improving completion rates inside the facility or after release. Studies that provided data about initiation and completion rates showed poor success in correctional facilities. Adverse consequences and treatment interruption ranged from 1% to 55% (median 5%) in reported studies; hepatotoxicity was the most prevalent adverse reaction. Despite its accelerating effect on the development of active TB, information on human immunodeficiency virus (HIV) status was provided in only half of the studies. Among the four studies where IPT effectiveness was assessed, the results mirror those described in community settings. Future studies require thorough assessments of IPT initiation and completion rates and adverse effects, particularly in low- and middle-income countries and where comorbid viral hepatitis may contribute significantly to outcomes, and in settings where TB and HIV are more endemic.

Matched MeSH terms: AIDS-Related Opportunistic Infections/epidemiology; AIDS-Related Opportunistic Infections/prevention & control
Tuberculosis in HIV/AIDS patients: a Malaysian experience

Nissapatorn V, Kuppusamy I, Sim BL, Quek KF, Khairul Anuar A

Southeast Asian J. Trop. Med. Public Health, 2005 Jul;36(4):946-53.
PMID: 16295550

This retrospective study was conducted at the National Tuberculosis Center (NTBC) where 252 HIV-positive patients coexisting with tuberculosis (TB/HIV) were examined. We found that patients with pulmonary (PTB) and extrapulmonary tuberculosis (EPT) had similar mean age. A higher sex ratio between male to female (10.7:1) was observed in patients with PTB. The other characteristics of patients with pulmonary and extrapulmonary tuberculosis were not statistically different from each other. Cough (88%) and hemoptysis were the most common presenting symptoms, significantly related to patients with PTB. Lymphadenopathy (33.5%) was the most common sign in patients with EPT. The majority of patients with pulmonary and extrapulmonary tuberculosis had CD4 cell counts of less than 200 cells/mm3 (range 0-1,179 with a median of 57 cells/mm3). Lung (89%) and miliary (55.6%) forms were the most frequent disease locations in patients with PTB and EPT, respectively. A higher percentage of patients with PTB (42%) were treated successfully with short-course (6 months) therapy, whereas in patients with EPT (43%) needed a longer period (9 months) for successful treatment. Of the patients who defaulted treatment, a higher proportion (87%) had PTB. No MDR-TB or relapse cases were found in this study.

Matched MeSH terms: AIDS-Related Opportunistic Infections/diagnosis*; AIDS-Related Opportunistic Infections/epidemiology*
Fulltext Cryptosporidiosis among HIV positive intravenous drug users in Malaysia

Kamel AG, Maning N, Arulmainathan S, Murad S, Nasuruddin A, Lai KP

Southeast Asian J. Trop. Med. Public Health, 1994 Dec;25(4):650-3.
PMID: 7667707

A study conducted at the Tampin Drug Rehabilitation Center in Malaysia established a high prevalence (23%) of asymptomatic carriers of Cryptosporidium among exposed HIV positive intravenous drug users (IVDUs). A majority of them were young adults and among the ethnic groups, the Malay HIV positive inmates had the highest prevalence of Cryptosporidium infection.

Matched MeSH terms: AIDS-Related Opportunistic Infections/epidemiology*; AIDS-Related Opportunistic Infections/transmission
Toxoplasmosis in HIV/AIDS patients: a current situation

Nissapatorn V, Lee C, Quek KF, Leong CL, Mahmud R, Abdullah KA

Jpn J Infect Dis, 2004 Aug;57(4):160-5.
PMID: 15329448

The seroprevalence of toxoplasmosis among 505 of human immunodeficiency virus (HIV)/AIDS patients was 226 (44.8%; 95% CI 42.64-51.76): 27 (47.4%) and 199 (44.4%) showed Toxoplasma seropositivity with and without toxoplasmic encephalitis (TE), respectively (P <0.05). The majority of these patients were in the 25-34 age group (44 versus 39%), male (86 versus 76%), and Chinese (49 versus 53%), though no statistical significance was found between the two. Significant differences between these two groups were noted, however, in terms of marital status, occupation, and present address. The heterosexual exhibited the most frequent behavior at risk for HIV infection, and accounted for 51 and 59% of patients with and without TE, respectively. Only 17/260 (6.5%) and 1/137 (0.7%) of them later acquired TE after receiving primary chemoprophylaxis (cotrimoxazole) and antiretroviral therapy including HAART (P <0.05). Fifty-seven (11.3%) out of those 505 patients were diagnosed with AIDS-related TE. The most common clinical manifestation was headache (56%). The computed tomography scan findings showed most lesions to be multiple (96.4%), hypodense (66.7%), and in the parietal region (39.3%). Twenty-seven (47.4%) patients had chronic (latent) Toxoplasma infection as evidenced by seropositivity for anti-Toxoplasma (IgG) antibody. At the time of diagnosis, the range of CD4 cell count was from 0-239 with a median of 25 cells/cumm. We also found that a CD4 count of less than 100 cells/cumm was significantly associated with development of TE (P <0.05). Clinical outcomes showed that among those who survived, 21 (36.8%), 16 (28.1%), and 2 (3.5%) of patients had completed treatment, transferred out, and were lost to follow up, respectively. Unfortunately, 18 (31.6%) of the cases were officially pronounced dead. Overall, 7 (12.3%) patients were detected as recurrent TE in this study.

Matched MeSH terms: AIDS-Related Opportunistic Infections/epidemiology*; AIDS-Related Opportunistic Infections/parasitology
Detection of IgM and IgG antibodies to Cryptococcus neoformans proteins in blood donors and HIV patients with active cryptococcosis

Chai HC, Tay ST

Mycoses, 2009 Mar;52(2):166-70.
PMID: 18643920 DOI: 10.1111/j.1439-0507.2008.01549.x

The serological responses to Cryptococcus neoformans proteins of blood donors and HIV patients with active cryptococcosis from a tropical region were investigated in this study. Exposure to C. neoformans, an organism ubiquitous in the environment, contributes to the antibody responses observed in the blood donors. IgG responses to cryptococcal proteins were stronger than IgM responses in most sera tested in this study. A 53-kDa cryptococcal protein fragment was identified as the most immunoreactive protein on the IgM immunoblots of both blood donors and patients. Overall, there was no obvious difference in IgG responses of patients when compared with blood donors. Some immunogenic protein fragments (27.5, 76, 78 and 91.5 kDa) were detected at least two times more frequently on IgM immunoblots of patients compared with those of blood donors. It is yet to be investigated whether the proteins identified in this study may have any potential to be used as biomarker for cryptococcosis.

Matched MeSH terms: AIDS-Related Opportunistic Infections/immunology*; AIDS-Related Opportunistic Infections/microbiology
Fulltext CNS toxoplasmosis induced hydrocephalus revisited and a brief review of AIDS dementia complex

Chow MB

Med J Malaysia, 2013 Jun;68(3):278.
PMID: 23749026
Matched MeSH terms: AIDS-Related Opportunistic Infections
Detection of microsporidia in local HIV-positive population in Malaysia

Lono A, Kumar S, Chye TT

Trans R Soc Trop Med Hyg, 2011 Jul;105(7):409-13.
PMID: 21596411 DOI: 10.1016/j.trstmh.2011.03.006

The HIV-positive population, due to their immuno-compromised nature, is considered more susceptible to parasitic infections than other populations. However despite the reports of other opportunistic pathogens such as Cryptosporidium and tuberculosis reported in vulnerable communities, microsporidia have not been highlighted in the local HIV-positive population in Malaysia. This study aimed to provide preliminary information on the prevalence of microsporidia in the local HIV-population. Microsporidia were detected in 21/247 (8.5%) stool samples from the HIV-infected individuals, a significantly higher (P-value <0.05) prevalence than in the control group, in which 5/173 (2.9%) were positive. HIV patients were 3x more at risk for acquiring microspordium (OR: 3.12; 95% CI 1.15-8.44). Spores were ellipsoid in shape with outlines that stained dark pink with the interior a lighter shade. Approximately 21% of the positive specimens were from individuals in the 40-49 years age group. Ten individuals who were positive for microsporidia were also positive for other enteric parasites such as Blastocystis hominis and Giardia lamblia. We detected Encephalitozoon intestinalis DNA following nested PCR from three of 10 samples analysed, as demonstrated by an amplicon of 370bp. From the findings reported, it appears that microsporidial infection in humans may actually be more common than reported. We strongly advocate greater emphasis on personal hygiene through public education on personal hygiene and the consumption of boiled or filtered water.

Matched MeSH terms: AIDS-Related Opportunistic Infections/diagnosis*; AIDS-Related Opportunistic Infections/microbiology; AIDS-Related Opportunistic Infections/epidemiology
Tuberculosis: clinical manifestations and outcomes

Nissapatorn V, Kuppusamy I, Anuar AK, Quek KF, Latt HM

Southeast Asian J. Trop. Med. Public Health, 2003;34 Suppl 2:147-52.
PMID: 19238668

A total of 290 HIV/AIDS patients were recruited into this retrospective study, which was carried out at the National Tuberculosis Center (NTBC), Kuala Lumpur. The age range was 18 to 75 years with a mean age of 36.10 (SD +/- 7.44) years. Males outnumbered females by a ratio of 31:1. In this study, the majority of patients were male (96.9%), Malay (47.2%), single (66.9%), unemployed (81%), and smoked (61.4%). The main risk marker identified was injecting drug use (74.5%). The most common clinical manifestations were cough, fever, sputum, lymphadenopathy, and chest infiltrations. More than half of the patients (85.9%) were diagnosed with localized tuberculosis (pulmonary) and the others (14.1%) had extra-pulmonary or disseminated tuberculosis. At the time of this study, the majority of the patients (16.9%) had CD4 cell counts of less than 200 cell/mm3, with a median of 221 cell/mm3. Clinical outcomes demonstrated that among those who survived, 11.0% and 20.7% of the patients had completed treatment either > or = 6 or > or = 9 months, respectively, whereas 54.8% of patients were lost to follow-up, including 0.7% for MDR-TB. Diagnostic criteria for tuberculosis in this study were mainly clinical symptoms/signs and chest x-ray findings (31.0%).

Matched MeSH terms: AIDS-Related Opportunistic Infections/drug therapy; AIDS-Related Opportunistic Infections/epidemiology; AIDS-Related Opportunistic Infections/physiopathology*
Fulltext Burden of Talaromyces marneffei infection in people living with HIV/AIDS in Asia during ART era: a systematic review and meta-analysis

Qin Y, Huang X, Chen H, Liu X, Li Y, Hou J, et al.

BMC Infect Dis, 2020 Jul 29;20(1):551.
PMID: 32727383 DOI: 10.1186/s12879-020-05260-8

BACKGROUND: Talaromyces marneffei (TM) is a dimorphic fungus mainly prevalent in Southeast Asian countries, which often causes disseminated life-threatening infection. TM infection often occurs in HIV/AIDS patients even in the antiretroviral therapy (ART) era. However, there has as yet, not been a systematic analysis of the prevalence of TM infection in HIV-infected populations in Asia.
METHODS: In this study, we searched Pubmed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and WanFang from inception to 21 November 2018 for studies reporting TM infection in people living with HIV/AIDS (PLWHA). Our meta-analysis included studies investigating the prevalence of TM infection in PLWHA. Reviews, duplicate studies, and animal studies were excluded. A random effects model was used to estimate pooled prevalence, and meta-regression analysis was conducted to explore potential factors for heterogeneity.
RESULTS: 159,064 patients with HIV infection in 33 eligible studies were included in our meta-analysis. The pooled prevalence of TM infection in PLWHA was 3.6%. Vietnam had the highest prevalence (6.4%), followed by Thailand (3.9%), China (3.3%), India (3.2%) and Malaysia (2.1%). In China, TM infection was most prevalent in South China (15.0%), while the burden in Southwest China was not very heavy (0.3%). CD4+ T-cell counts below 200 cells/mm3 contributed to the increased risk of TM infection in PLWHA (OR 12.68, 95%CI: 9.58-16.77). However, access to ART did not significantly decrease the risk of TM infection in PLWHA.
CONCLUSIONS: The burden of TM infection in Asia is heavy, and varies from region to region. PLWHA in lower latitude areas are more likely to suffer from TM infection. Optimization of diagnostic tools and universal screening for TM in vulnerable people to ensure early case detection and prompt antifungal treatment should be considered.

Matched MeSH terms: AIDS-Related Opportunistic Infections/drug therapy*; AIDS-Related Opportunistic Infections/epidemiology*; AIDS-Related Opportunistic Infections/virology
Cutaneous manifestations of patients with Human Immunodeficiency Virus (HIV) Infection: A retrospective review of a tertiary referral centre with clinicopathological correlation

Han WH, Yong JY, Yong SS, Faheem NAA, Toh YF, Chew MF, et al.

Australas J Dermatol, 2021 Aug;62(3):286-291.
PMID: 33729571 DOI: 10.1111/ajd.13580

INTRODUCTION: The majority of patients with Human Immunodeficiency Virus (HIV) will have cutaneous manifestation during their disease course. We report the spectrum of cutaneous manifestations and clinicopathological concordance in the diagnosis of skin diseases in patients with HIV.
METHODS: A retrospective review of all cutaneous manifestations of HIV-infected patients with skin biopsy-proven histopathological confirmation, treated in the University of Malaya Medical Centre, from 2016 till 2018, was performed. Clinical characteristics and histopathological correlation of these patients were reviewed.
RESULTS: A total of 38 cases were included where the median age was 40.5 (interquartile range (IQR) 13.3). The median duration of HIV diagnosis to the development of skin disease was 3 years (IQR 7.8). Majority of our patients were male (89.5%, n = 34), and the commonest mode of transmission is men who have sex with men (36.8%, n = 14). Most patients (92.1%, n = 35) had Acquired Immunodeficiency Syndrome when they presented with skin diseases, predominantly non-infectious types (51.4%, n = 19). Commonest skin diseases include eczema (n = 7) and pruritic papular eruption of HIV (n = 6). Papules and plaques were the commonest morphology for both infectious and non-infectious skin diseases. Duration of HIV diagnosis (P = 0.018) and non-compliance to Highly Active Antiretroviral Therapy (HAART) (P = 0.014) were significantly associated with the development of non-infectious skin diseases. Overall, clinicopathological concordance was 84.2% in our centre.
CONCLUSION: A wide spectrum of cutaneous diseases can occur in HIV patients depending on the degree of immunosuppression. skin biopsy along with appropriate stains, and microbiological cultures are important in helping clinicians clinch the right diagnosis.

Matched MeSH terms: AIDS-Related Opportunistic Infections/complications*; AIDS-Related Opportunistic Infections/drug therapy; AIDS-Related Opportunistic Infections/pathology

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