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  • Bakari, M, et al. (författare)
  • The prevalence and pattern of skin diseases in relation to CD4 counts among HIV-infected police officers in Dar es Salaam
  • 2003
  • Ingår i: Tropical doctor. - : SAGE Publications. - 0049-4755 .- 1758-1133. ; 33:1, s. 44-48
  • Tidskriftsartikel (refereegranskat)abstract
    • Among HIV-infected individuals, skin diseases cause significant morbidity and are frequently the initial indication of immunosuppression. From an on-going cohort study to determine prevalence and incidence of HIV infection among police officers (POs) and their suitability for HIV vaccine trials, a sub-study was carried out to determine the prevalence and pattern of skin diseases among HIV-infected POs and relate this to their immunodeficiency status. Consenting HIV-infected POs and their age and sex-matched HIV-negative officers were assessed for presence and type of skin diseases at their workplaces. A questionnaire was used for data collection. Immunodeficiency was measured by plasma CD4+ lymphocytes using flow cytometry. Between November 1998 and 31 December 2000, 716 POs were assessed. Overall HIV-1 prevalence was 17.7% (127/716). One hundred and ninety-one POs (26.7%) had at least one skin diagnosis. HIV-infected POs had significantly higher (41.7%) prevalence of skin diseases than HIV-uninfected POs (26.4%), P=0.002. Fungal infections were common in both HIV-infected and uninfected POs. Among the HIV infected, other common diseases were: Herpes zoster (11.8%); pruritic papular eruption (PPE) (7.1%); seborrheic dermatitis (5.5%); and Kaposi's sarcoma (KS) (1.6%). KS and PPE were associated with severe immunodeficiency, with mean absolute (percentage) CD4+ counts of 75.5 cells/μL (4.0%) and 71.7 cells/μL (4.8%), respectively. The values for herpes zoster and seborrheic dermatitis were 271.1 cells/μL (12.4%) and 206.3 cells/μL (11.3%), respectively. Skin diseases were common among HIV-infected POs. PPE and KS are markers of severe immunodeficiency due to HIV. PPE, herpes zoster and KS strongly suggest underlying HIV-related immunodeficiency and patients with these conditions should be counselled and tested for HIV.
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