Login Register Cart 0
Generic placeholder image

Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Mucocutaneous Manifestations of People Living with HIV in Current Antiretroviral Therapy Era

Author(s): Onur Sivaz*, Ezgi Ozkur, Ilknur Kivanc Altunay, Ahsen Oncul and Dilek Yıldız Sevgi

Volume 20, Issue 2, 2022

Published on: 21 April, 2022

Page: [120 - 128] Pages: 9

DOI: 10.2174/1570162X20666220302141504

Price: $65

Abstract

Objective: It has been reported that approximately 90 % of patients infected with the human immunodeficiency virus (HIV) have various cutaneous symptoms related to the virus. This study aims to describe the cutaneous disorders that have developed in HIV-infected patients and to investigate the factors that may be related, such as relationships to drug use and CD4 counts.

Methods: This cross-sectional study included people living with HIV and being followed by our hospital’s infectious diseases clinic after being referred to the dermatology clinic because of skin lesions. These patients had been diagnosed with HIV by enzyme-linked immunosorbent assay tests and were included in the study if they were older than 18 years and had agreed to participate. Findings from detailed dermatological examinations were recorded, along with the patients’ CD4 counts, the durations of their illnesses, and the treatments they received.

Results: 144 patients were included in the study. The most common mucocutaneous manifestation was seborrheic dermatitis, at 28.5 % (n = 41). The mean CD4 count was 607.1 (min-max = 10.6- 1982). The CD4 counts were divided into three groups in the study as follows: 22 (15.3 %) patients with <200, 35 (24.3 seborrheic dermatitis) patients between 200 and 500, and 87 (60.4 %) patients with >500. There were no statistical differences between these groups in terms of dermatological findings. Nevertheless, the highest rate of patients with three or more dermatological conditions was found among those with CD4 counts <200 (n = 11.50 %).

Conclusion: Skin manifestations are common in patients who are HIV-positive; however, many skin disorders can be seen in HIV/acquired immunodeficiency syndrome (AIDS) patients whatever CD4 cell counts of these patients are.

Keywords: Cutaneous manifestations, HIV, AIDS, CD4 count, antiretroviral therapy, Turkey, seborrheic dermatitis.

« Previous Next »
[1]
Orenstein R. Presenting syndromes of human immunodeficiency virus. Mayo Clin Proc 2002; 77: 1097-102.
[http://dx.doi.org/10.4065/77.10.1097]
[2]
Teixeira AI, Neno M, Badura R, Borges-Costa J, Filipe PL. Kaposi Sarcoma of the eyelid as an initial manifestation of AIDS. Dermatol Online J 2016; 22(7): 13030/qt2jw6t7cs..
[http://dx.doi.org/10.5070/D3227031649] [PMID: 27617725]
[3]
Dlova N, Mosam A. Cutaneous manifestations of HIV/AIDS: Part I. South Afr J HIV Med 2004; 5(4): 12-7.
[4]
Sud N, Shanker V, Sharma A, Sharma NL, Gupta M. Mucocutaneous manifestations in 150 HIV-infected Indian patients and their relationship with CD4 lymphocyte counts. Int J STD AIDS 2009; 20(11): 771-4.
[http://dx.doi.org/10.1258/ijsa.2009.009092] [PMID: 19778955]
[5]
Azfar NA, Khan AR, Zia MA, Malik LM, Jahangir M. Frequency of mucocutaneous manifestations in HIV positive Pakistani patients. J Pak Assoc Dermatol 2016; 21(3): 149-53.
[6]
Kore SD, Kanwar AJ, Vinay K, Wanchu A. Pattern of mucocutaneous manifestations in human immunodeficiency virus-positive patients in North India. Indian J Sex Transm Dis AIDS 2013; 34(1): 19-24.
[http://dx.doi.org/10.4103/0253-7184.112865] [PMID: 23919050]
[7]
Coopman SA, Johnson RA, Platt R, Stern RS. Cutaneous disease and drug reactions in HIV infection. N Engl J Med 1993; 328(23): 1670-4.
[http://dx.doi.org/10.1056/NEJM199306103282304] [PMID: 8487826]
[8]
Tschachler E, Bergstresser PR, Stingl G. HIV-related skin diseases. Lancet 1996; 348(9028): 659-63.
[http://dx.doi.org/10.1016/S0140-6736(96)01032-X] [PMID: 8782758]
[9]
Uthayakumar S, Nandwani R, Drinkwater T, Nayagam AT, Darley CR. The prevalence of skin disease in HIV infection and its relationship to the degree of immunosuppression. Br J Dermatol 1997; 137(4): 595-8.
[http://dx.doi.org/10.1111/j.1365-2133.1997.tb03793.x] [PMID: 9390338]
[10]
Brinchmann JE. Differential responses of T cell subsets: Possible role in the immunopathogenesis of AIDS. AIDS 2000; 14(12): 1689-700.
[http://dx.doi.org/10.1097/00002030-200008180-00002] [PMID: 10985304]
[11]
Tschachler E, Groh V, Popovic M, et al. Epidermal Langerhans cells-A target for HTLV-III/LAV infection. J Invest Dermatol 1987; 88(2): 233-7.
[http://dx.doi.org/10.1111/1523-1747.ep12525402] [PMID: 3100656]
[12]
Langhoff E, Terwilliger EF, Bos HJ, et al. Replication of human immunodeficiency virus type 1 in primary dendritic cell cultures. Proc Natl Acad Sci USA 1991; 88(18): 7998-8002.
[http://dx.doi.org/10.1073/pnas.88.18.7998] [PMID: 1910172]
[13]
Prabhakaran N, Jaisankar TJ, Hamide A, Malathi M, Kumari R, Thappa DM. Effect of antiretroviral therapy on mucocutaneous manifestations among human immunodeficiency virus-infected patients in a tertiary care centre in South India. Indian J Sex Transm Dis AIDS 2015; 36(2): 166-73.
[http://dx.doi.org/10.4103/0253-7184.167160] [PMID: 26692610]
[14]
Garman ME, Tyring SK. The cutaneous manifestations of HIV infection. Dermatol Clin 2002; 20(2): 193-208.
[http://dx.doi.org/10.1016/S0733-8635(01)00011-0] [PMID: 12120434]
[15]
Okoboi S, Castelnuovo B, Moore DM, et al. Risky sexual behavior among patients on long-term antiretroviral therapy: A prospective cohort study in urban and rural Uganda. AIDS Res Ther 2018; 15(1): 15.
[http://dx.doi.org/10.1186/s12981-018-0203-1] [PMID: 30340608]
[16]
Boily MC, Godin G, Hogben M, Sherr L, Bastos FI. The impact of the transmission dynamics of the HIV/AIDS epidemic on sexual behaviour: A new hypothesis to explain recent increases in risk taking-behaviour among men who have sex with men. Med Hypotheses 2005; 65(2): 215-26.
[http://dx.doi.org/10.1016/j.mehy.2005.03.017] [PMID: 15922091]
[17]
Kennedy C, O’Reilly K, Medley A, Sweat M. The impact of HIV treatment on risk behaviour in developing countries: A systematic review. AIDS Care 2007; 19(6): 707-20.
[http://dx.doi.org/10.1080/09540120701203261] [PMID: 17573590]
[18]
Chow EPF, Grulich AE, Fairley CK. Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV. Lancet HIV 2019; 6(6): e396-405.
[http://dx.doi.org/10.1016/S2352-3018(19)30043-8] [PMID: 31006612]
[19]
Altman K, Vanness E, Westergaard RP. Cutaneous manifestations of human immunodeficiency virus: A clinical update. Curr Infect Dis Rep 2015; 17(3): 464.
[http://dx.doi.org/10.1007/s11908-015-0464-y] [PMID: 25821188]
[20]
Abel EA. Cutaneous manifestations of immunosuppression in organ transplant recipients. J Am Acad Dermatol 1989; 21(2 Pt 1): 167-79.
[http://dx.doi.org/10.1016/S0190-9622(89)70157-2] [PMID: 2671063]
[21]
Altuntaş Aydin Ö, Kumbasar Karaosmanoğlu H, Korkusuz R, Özeren M, Özcan N. Mucocutaneous manifestations and the relationship to CD4 lymphocyte counts among Turkish HIV/AIDS patients in Istanbul, Turkey. Turk J Med Sci 2015; 45(1): 89-92.
[http://dx.doi.org/10.3906/sag-1308-3] [PMID: 25790535]
[22]
Huang X-J, Li HY, Chen DX, et al. Clinical analysis of skin lesions in 796 Chinese HIV- positive patients. Acta Derm Venereol 2011; 91(5): 552-6.
[http://dx.doi.org/10.2340/00015555-1107] [PMID: 21597675]
[23]
Boushab BM, Malick Fall FZ, Ould Cheikh Mohamed Vadel TK, et al. Mucocutaneous manifestations in human immunodeficiency virus (HIV)-infected patients in Nouakchott, Mauritania. Int J Dermatol 2017; 56(12): 1421-4.
[http://dx.doi.org/10.1111/ijd.13737] [PMID: 28960268]
[24]
Erdinc FS, Dokuzoguz B, Unal S, et al. Temporal trends in the epidemiology of HIV in Turkey. Curr HIV Res 2020; 18(4): 258-66.
[http://dx.doi.org/10.2174/1570162X18666200427223823] [PMID: 32342820]
[25]
Shehu E, Harxhi A, Simaku A. Cutaneous manifestations of human immunodeficiency Virus/AIDS patients in Albania. Int J Appl Basic Med Res 2019; 9(4): 197-200.
[http://dx.doi.org/10.4103/ijabmr.IJABMR_287_18] [PMID: 31681542]
[26]
26. UNAIDS, U., UNAIDS data 2017. Jt. United Nations Program. HIV AIDS (Auckl) 2017; 1-248.
[27]
Mirnezami M, Zarinfar N, Sofian M, Botlani Yadegar B, Rahimi H. Mucocutaneous manifestations in HIV-infected patients and their relationship to CD4 lymphocyte counts. Scientifica (Cairo) 2020; 2020: 7503756.
[http://dx.doi.org/10.1155/2020/7503756] [PMID: 32850174]
[28]
Singh H, Singh P, Tiwari P, Dey V, Dulhani N, Singh A. Dermatological manifestations in HIV-infected patients at a tertiary care hospital in a tribal (Bastar) region of Chhattisgarh, India. Indian J Dermatol 2009; 54(4): 338-41.
[http://dx.doi.org/10.4103/0019-5154.57609] [PMID: 20101334]
[29]
Chawhan SM, Bhat DM, Solanke SM. Dermatological manifestations in human immunodeficiency virus infected patients: Morphological spectrum with CD4 correlation. Indian J Sex Transm Dis AIDS 2013; 34(2): 89-94.
[http://dx.doi.org/10.4103/0253-7184.120538] [PMID: 24339458]
[30]
Vasudevan B, Sagar A, Bahal A, Mohanty A. Cutaneous manifestations of HIV-a detailed study of morphological variants, markers of advanced disease, and the changing spectrum. Med J Armed Forces India 2012; 68(1): 20-7.
[http://dx.doi.org/10.1016/S0377-1237(11)60122-6] [PMID: 24669034]
[31]
Freytes DM, Arroyo-Novoa CM, Figueroa-Ramos MI, Ruiz-Lebrón RB, Stotts NA, Busquets A. Skin disease in HIV-positive persons living in Puerto Rico. Adv Skin Wound Care 2007; 20(3): 149-150, 152-156.
[http://dx.doi.org/10.1097/01.ASW.0000262711.97411.a1] [PMID: 17473721]
[32]
Cedeno-Laurent F, Gómez-Flores M, Mendez N, et al. New insights into HIV-1-primary skin disorders. J Int AIDS Soc 2011; 14(1): 5.
[http://dx.doi.org/10.1186/1758-2652-14-5] [PMID: 21261982]
[33]
Mawenzi RL, Oguttu OR, Williams HC. Epidemiology and clinical spectrum of cutaneous diseases manifesting among newly diagnosed HIV seropositive adults in Nakuru county-Kenya. J Med Res 2013; 7(1): 1-9.
[http://dx.doi.org/10.5707/cjmedres.2012.7.1.1.9]
[34]
Organization WH. WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children 2007. Available from: https://apps.who.int/iris/handle/10665/43699
[35]
Coldiron BM, Bergstresser PR. Prevalence and clinical spectrum of skin disease in patients infected with human immunodeficiency virus. Arch Dermatol 1989; 125(3): 357-61.
[http://dx.doi.org/10.1001/archderm.1989.01670150047004] [PMID: 2522293]
[36]
Rico MJ, Myers SA, Sanchez MR. Guidelines/Outcomes Committee. American academy of dermatology. Guidelines of care for dermatologic conditions in patients infected with HIV. J Am Acad Dermatol 1997; 37(3 Pt 1): 450-72.
[PMID: 9308562]
[37]
Wiwanitkit V. Prevalence of dermatological disorders in Thai HIV-infected patients correlated with different CD4 lymphocyte count statuses: A note on 120 cases. Int J Dermatol 2004; 43(4): 265-8.
[http://dx.doi.org/10.1111/j.1365-4632.2004.01649.x] [PMID: 15090008]
[38]
Zancanaro PC, McGirt LY, Mamelak AJ, Nguyen RH, Martins CR. Cutaneous manifestations of HIV in the era of highly active antiretroviral therapy: An institutional urban clinic experience. J Am Acad Dermatol 2006; 54(4): 581-8.
[http://dx.doi.org/10.1016/j.jaad.2005.12.030] [PMID: 16546578]
[39]
Chua Serling SL, Leslie K, Maurer T. Approach to pruritus in the adult HIV-positive patient. Semin Cutan Med Surg 2011; 30(2): 101-6.
[PMID: 21767771]
[40]
Li YY, Yang SH, Wang RR, Tang JT, Wang HM, Kuang YQ. Effects of CD4 cell count and antiretroviral therapy on mucocutaneous manifestations among HIV/AIDS patients in Yunnan, China. Int J Dermatol 2020; 59(3): 308-13.
[http://dx.doi.org/10.1111/ijd.14725] [PMID: 31846069]
[41]
Itin PH, Lautenschlager S, Flückiger R, Rufli T. Oral manifestations in HIV-infected patients: Diagnosis and management. J Am Acad Dermatol 1993; 29(5 Pt 1): 749-60.
[http://dx.doi.org/10.1016/0190-9622(93)70241-K] [PMID: 8227548]
[42]
Basida SD, Basida B, Zalavadiya N, Trivedi AP. Dermatological opportunistic infections in HIV seropositive patients: An observational study. Cureus 2021; 13(8): e16852.
[http://dx.doi.org/10.7759/cureus.16852] [PMID: 34513432]
[43]
Ashwini PK, Betkerur J, Shastry V. Study of mucocutaneous manifestations of HIV and its relation to total lymphocyte count. Indian J Sex Transm Dis AIDS 2020; 41(1): 47-52.
[http://dx.doi.org/10.4103/2589-0557.229947] [PMID: 33062982]
[44]
Balighi K, Soori T, Fouladi N. Mucocutaneous manifestations as the first presentations of HIV infection Iranian J Dermtol 2013; 16(65): 105-8.
[45]
Fatahzadeh M, Schwartz RA. Human herpes simplex virus infections: Epidemiology, pathogenesis, symptomatology, diagnosis, and management. J Am Acad Dermatol 2007; 57(5): 737-63.
[http://dx.doi.org/10.1016/j.jaad.2007.06.027] [PMID: 17939933]
[46]
Umar SH, Kanth A. Disseminated cutaneous herpes simplex virus type-1 with interstitial pneumonia as a first presentation of AIDS. J Natl Med Assoc 1999; 91(8): 471-4.
[PMID: 12656437]
[47]
Fernandez-Nieto D, Jimenez-Cauhe J, Ortega-Quijano D, Burgos-Blasco P, Pindado-Ortega C, Bea-Ardebol S. A case of atypical disseminated herpes simplex virus 1 with hepatitis in a liver transplant recipient: The need for dermatologic evaluation. Dermatol Online J 2020; 26(2): 13030/qt3k90n5s9.
[http://dx.doi.org/10.5070/D3262047422] [PMID: 32239894]
[48]
Brown P, Elmasry S, Olagunju A, Garcia S, Sarihan M. A case of disseminated cutaneous herpes simplex virus-1 as the first manifestation of human immunodeficiency virus infection. J Investig Med High Impact Case Rep 2021; 9: 23247096211045245.
[http://dx.doi.org/10.1177/23247096211045245] [PMID: 34521234]
[49]
Titou H, Ebongo C, Hjira N. Dermatologic manifestations among human immunodeficiency virus patients in Morocco and association with immune status. Int J Dermatol 2018; 57(2): 156-61.
[http://dx.doi.org/10.1111/ijd.13864] [PMID: 29243825]
[50]
Drozd B, Andriescu E, Suárez A, De la Garza Bravo MM. Cutaneous cytomegalovirus manifestations, diagnosis, and treatment: A review. Dermatol Online J 2019; 25(1): 13030/qt84f936cp.
[http://dx.doi.org/10.5070/D3251042608] [PMID: 30710895]
[51]
Sarigül F, Sayan M, İnan D, et al. Current status of HIV/AIDS-syphilis co-infections: A retrospective multicentre study. Cent Eur J Public Health 2019; 27(3): 223-8.
[PMID: 31580558]
[52]
Köksal MO, Beka H, Evlice O, et al. Syphilis seroprevalence among HIV-infected males in Istanbul, Turkey. Rev Argent Microbiol 2020; 52(4): 266-71.
[http://dx.doi.org/10.1016/j.ram.2020.01.002] [PMID: 32178940]
[53]
Shilaih M, Marzel A, Braun DL, et al. Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals. Medicine (Baltimore) 2017; 96(2): e5849.
[http://dx.doi.org/10.1097/MD.0000000000005849] [PMID: 28079818]
[54]
Lima VD, Brumme ZL, Brumme C, et al. The impact of treatment as prevention on the HIV epidemic in British Columbia, Canada. Curr HIV/AIDS Rep 2020; 17(2): 77-87.
[http://dx.doi.org/10.1007/s11904-020-00482-6] [PMID: 32124189]
[55]
Allen H, Kirwan P, Brown AE, et al. Does being on HIV antiretroviral therapy increase the risk of syphilis? An analysis of a large national cohort of MSM living with HIV in England 2009-2016. Sex Transm Infect 2021; 97(3): 221-5.
[http://dx.doi.org/10.1136/sextrans-2020-054603] [PMID: 33172915]
[56]
Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev 1995; 8(1): 1-21.
[http://dx.doi.org/10.1128/CMR.8.1.1] [PMID: 7704889]
[57]
Jurado RL, Campbell J, Martin PD. Prozone phenomenon in secondary syphilis. Has its time arrived? Arch Intern Med 1993; 153(21): 2496-8.
[http://dx.doi.org/10.1001/archinte.1993.00410210124014] [PMID: 7832818]
[58]
Smith G, Holman RP. The prozone phenomenon with syphilis and HIV-1 co-infection. South Med J 2004; 97(4): 379-82.
[http://dx.doi.org/10.1097/01.SMJ.0000121204.58881.60] [PMID: 15108832]
[59]
Nnoruka EN, Ezeoke AC. Evaluation of syphilis in patients with HIV infection in Nigeria. Trop Med Int Health 2005; 10(1): 58-64.
[http://dx.doi.org/10.1111/j.1365-3156.2004.01344.x] [PMID: 15655014]
[60]
Davarpanah MA, Motazedian N, Jowkar F. Dermatological manifestations of HIV/AIDS individuals in Shiraz, South of Iran. J Glob Infect Dis 2018; 10(2): 80-3.
[http://dx.doi.org/10.4103/0974-777X.233000] [PMID: 29910568]
[61]
Christophers E. Psoriasis-epidemiology and clinical spectrum. Clin Exp Dermatol 2001; 26(4): 314-20.
[http://dx.doi.org/10.1046/j.1365-2230.2001.00832.x] [PMID: 11422182]
[62]
Yaylı S, Topbas M, Arica DA, Tuğcugil S, Çapkın E, Bahadır S. Trabzon ilinde psoriasis prevalansı. Turkderm Turk Arch Dermatol 2016; 50(4): 141-4.
[http://dx.doi.org/10.4274/turkderm.75735]
[63]
Kaplan MH, Sadick NS, Wieder J, Farber BF, Neidt GW. Antipsoriatic effects of zidovudine in human immunodeficiency virus-associated psoriasis. J Am Acad Dermatol 1989; 20(1): 76-82.
[http://dx.doi.org/10.1016/S0190-9622(89)70011-6] [PMID: 2913083]
[64]
Duvic M, Johnson TM, Rapini RP, Freese T, Brewton G, Rios A. Acquired immunodeficiency syndrome-associated psoriasis and Reiter’s syndrome. Arch Dermatol 1987; 123(12): 1622-32.
[http://dx.doi.org/10.1001/archderm.1987.01660360050012] [PMID: 3688903]
[65]
Obuch ML, Maurer TA, Becker B, Berger TG. Psoriasis and human immunodeficiency virus infection. J Am Acad Dermatol 1992; 27(5 Pt 1): 667-73.
[http://dx.doi.org/10.1016/0190-9622(92)70234-7] [PMID: 1430384]
[66]
Muñoz-Pérez MA, Rodriguez-Pichardo A, Camacho F, Colmenero MA. Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 year study of 1161 patients with human immunodeficiency virus disease predominantly acquired through intravenous drug abuse. Br J Dermatol 1998; 139(1): 33-9.
[http://dx.doi.org/10.1046/j.1365-2133.1998.02310.x] [PMID: 9764146]
[67]
Garbe C, Husak R, Orfanos C. HIV-associated dermatoses and their prevalence in 456 HIV-infected patients. Relation to immune status and its importance as a diagnostic marker. Hautarzt 1994; 45(9): 623-9.
[PMID: 7960770]
[68]
Borgia F, Ciodaro F, Guarneri F, et al. Auditory system involvement in psoriasis. Acta Derm Venereol 2018; 98(7): 655-9.
[http://dx.doi.org/10.2340/00015555-2937] [PMID: 29648672]
[69]
Castillo RL, Racaza GZ, Roa FD. Ostraceous and inverse psoriasis with psoriatic arthritis as the presenting features of advanced HIV infection. Singapore Med J 2014; 55(4): e60-3.
[http://dx.doi.org/10.11622/smedj.2014062] [PMID: 24763845]
[70]
Yen YF, Chuang PH, Jen IA, et al. Incidence of autoimmune diseases in a nationwide HIV/AIDS patient cohort in Taiwan, 2000-2012. Ann Rheum Dis 2017; 76(4): 661-5.
[http://dx.doi.org/10.1136/annrheumdis-2016-209815] [PMID: 27590658]
[71]
Kaplan MH, Sadick N, McNutt NS, Meltzer M, Sarngadharan MG, Pahwa S. Dermatologic findings and manifestations of acquired immunodeficiency syndrome (AIDS). J Am Acad Dermatol 1987; 16(3 Pt 1): 485-506.
[http://dx.doi.org/10.1016/S0190-9622(87)70066-8] [PMID: 2950145]
[72]
Han J, Lun WH, Meng ZH, et al. Mucocutaneous manifestations of HIV-infected patients in the era of HAART in Guangxi Zhuang autonomous Region, China. J Eur Acad Dermatol Venereol 2013; 27(3): 376-82.
[http://dx.doi.org/10.1111/j.1468-3083.2011.04429.x] [PMID: 22212015]
[73]
Rad F, Ghaderi F, Moradi G, Mafakheri L. The relationship between skin manifestations and CD4 counts among HIV positive patients. Pak J Med Sci 2008; 24(1): 114-7.
[74]
Simard EP, Pfeiffer RM, Engels EA. Cumulative incidence of cancer among individuals with acquired immunodeficiency syndrome in the United States. Cancer 2011; 117(5): 1089-96.
[http://dx.doi.org/10.1002/cncr.25547] [PMID: 20960504]
[75]
Ottria L, Lauritano D, Oberti L, et al. Prevalence of HIV-related oral manifestations and their association with HAART and CD4+ T cell count: A review. J Biol Regul Homeost Agents 2018; 32(2)(Suppl. 1): 51-9.
[PMID: 29460518]
[76]
Palella FJ Jr, Delaney KM, Moorman AC, et al. HIV Outpatient Study Investigators. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med 1998; 338(13): 853-60.
[http://dx.doi.org/10.1056/NEJM199803263381301] [PMID: 9516219]
[77]
Badri M, Wilson D, Wood R. Effect of highly active antiretroviral therapy on incidence of tuberculosis in South Africa: A cohort study. Lancet 2002; 359(9323): 2059-64.
[http://dx.doi.org/10.1016/S0140-6736(02)08904-3] [PMID: 12086758]
[78]
Moore RD, Chaisson RE. Natural history of HIV infection in the era of combination antiretroviral therapy. AIDS 1999; 13(14): 1933-42.
[http://dx.doi.org/10.1097/00002030-199910010-00017] [PMID: 10513653]
[79]
Ives NJ, Gazzard BG, Easterbrook PJ. The changing pattern of AIDS-defining illnesses with the introduction of highly active antiretroviral therapy (HAART)in a London clinic. J Infect 2001; 42(2): 134-9.
[http://dx.doi.org/10.1053/jinf.2001.0810] [PMID: 11531320]
[80]
San-Andrés F-J, Rubio R, Castilla J, et al. Incidence of acquired immunodeficiency syndrome-associated opportunistic diseases and the effect of treatment on a cohort of 1115 patients infected with human immunodeficiency virus, 1989-1997. Clin Infect Dis 2003; 36(9): 1177-85.
[http://dx.doi.org/10.1086/374358] [PMID: 12715314]
[81]
Dereje N, Moges K, Nigatu Y, Holland R. Prevalence and predictors of opportunistic infections among hiv positive adults on antiretroviral therapy (On-ART) Versus Pre-ART In Addis Ababa, Ethiopia: A comparative cross-sectional study. HIV AIDS (Auckl) 2019; 11: 229-37.
[http://dx.doi.org/10.2147/HIV.S218213] [PMID: 31632155]
[82]
Arefaine ZG, Abebe S, Bekele E, et al. Incidence and predictors of HIV related opportunistic infections after initiation of highly active antiretroviral therapy at Ayder referral hospital, Mekelle, Ethiopia: A retrospective single centered cohort study. PLoS One 2020; 15(4): e0229757.
[http://dx.doi.org/10.1371/journal.pone.0229757] [PMID: 32310961]
[83]
Chepkondol GK, Jolly PE, Yatich N, Mbowe O, Jaoko WG. Types and prevalence of HIV-related opportunistic infections/conditions among HIV-positive patients attending Kenyatta National Hospital in Nairobi, Kenya. Afr Health Sci 2020; 20(2): 615-24.
[http://dx.doi.org/10.4314/ahs.v20i2.9] [PMID: 33163022]

Rights & Permissions Print Cite
Article Metrics
27
1
© 2024 Bentham Science Publishers | Privacy Policy