Page 335 - HIVMED_v21_i1.indb

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 7 Original Research

The prevalence and spectrum of

mucocutaneous disease in South African

people living with HIV and accessing

care at a district-level hospital

Author: Background: Although the association between human immunodeficiency virus (HIV) and
Saskya Claasens mucocutaneous diseases has been well studied within South African specialist centres,
1
Susanna M.H. Kannenberg
1
1
Henry F. Jordaan there is limited data from district-level hospitals. Available data may, therefore, fail to
Karis Moxley 2 reflect the prevalence and full spectrum of dermatoses seen in people living with HIV
1,3
Rhodine Smith (PLWH).
Johann de Wet 1
Willem I. Visser 1 Objectives: To determine the prevalence and spectrum of dermatoses seen in PLWH.
Affiliations: Method: We conducted a cross-sectional, descriptive study of 970 PLWH (men and women,
1 Division of Dermatology,
Department of Medicine, ≥ 18 years old) accessing care at Karl Bremer Hospital, a district-level hospital located in
Faculty of Medicine and the Western Cape province, South Africa, between 01 September 2016 and 28 February
Health Sciences, Stellenbosch 2017.
University, Cape Town,
South Africa Results: The prevalence of mucocutaneous disease in this sample was 12.7% (95% confidence
interval [CI] 0.11–0.15). Non-infectious dermatoses comprised 71.0% of the disorders. Pruritic
2 Research Development and papular eruption (20.0%) and seborrheic dermatitis (6.0%) were the most common non-
Support Division, Faculty of
Medicine and Health Sciences, infectious dermatoses. Tinea corporis (8.0%) and oral candidiasis (6.0%) were the most
Stellenbosch University, Cape prevalent infectious dermatoses. There was no significant association between skin disease
Town, South Africa category (infectious or non-infectious dermatoses) and patient demographics (gender and
ethnicity) or HIV-disease characteristics (CD4+ cell count, viral load and duration of
3 Division of Epidemiology
and Biostatistics, Department antiretroviral therapy [ART]).
of Global Health, Faculty of Conclusion: This study provides valuable scientific data on the prevalence and spectrum of
Medicine and Health Sciences,
Stellenbosch University, Cape mucocutaneous disease in PLWH attending a South African district-level hospital. Prospective
Town, South Africa studies conducted in other district-level centres across the country are required to determine
the lifetime prevalence and spectrum of dermatoses in PLWH in the ART era.
Corresponding author:
Saskya Claasens, Keywords: mucocutaneous disease; HIV; district-level hospitals; ART; South Africa.
[email protected]
Dates:
Received: 16 Aug. 2020 Introduction
Accepted: 04 Sept. 2020
Published: 10 Dec. 2020 The skin serves as an important clinical tool in the diagnosis and staging of patients with human
immunodeficiency virus (HIV) and may be a marker of disease progression. Skin diseases are
How to cite this article:
Claasens S, Kannenberg SMH, common and well described in the HIV-positive population and may affect up to 90% of
1,2
Jordaan HF, et al. The individuals during the course of their illness. Although many skin and mucosal diseases are
prevalence and spectrum of not unique to people living with HIV (PLWH), these patients can present with atypical features
mucocutaneous disease in 3
South African people living and dual or triple pathology. Furthermore, infective and inflammatory dermatoses in PLWH
with HIV and accessing care at tend to be more severe and slower to respond to treatment when compared with the HIV-
a district-level hospital. S Afr J negative population. 4
HIV Med. 2020;21(1), a1154.
https://doi.org/10.4102/
sajhivmed.v21i1.1154 Antiretroviral therapy (ART) has altered the natural progression of HIV infection, leading
to immune reconstitution through the suppression of viral replication and the recovery of
the CD4+ cell count. As a result of ART, PLWH are living longer and healthier lives with a
Read online: near-normal life expectancy. Several of the HIV-associated dermatoses have declined
Read online:
5
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code with your during the ART era, but certain drug reactions and inflammatory skin conditions
smart phone or have increased. Management of PLWH in the ART era includes addressing common
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4,6
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Copyright: © 2020. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
http://www.sajhivmed.org.za 327 Open Access