Auswirkungen und Veränderungen bei HIV-assoziierten Hauterkrankungen durch HAART (Highly Active Antiretroviral Therapy)

Prevalence of HIV-associated skin diseases under HAART (highly active antiretroviral therapy) Introduction: The spectrum of skin diseases in HIV-infected patients is wide, with cutaneous infections being most common. The introduction of highly active antiretroviral therapy [HAART], especially in combination with protease inhibitors, strongly improved the immune functions and reduced the incidence, morbidity and lethality of HIV associated opportunistic infections [OI]. In order to evaluate the functional immune reconstitution under HAART, with the increasing number of CD4-T cells, we analysed frequency and severity of HIV associated skin diseases. Methods: In a retrospective study we selected two different cohorts of the HIV outpatient clinic, Department of Dermatology and Allergology, University of Munich. Cohort I included 157 HIV-infected patients treated with HAART, documented from 1996-98. Cohort II included 753 HIV-infected patients without HAART, documented from 1985-95. Mantel-Haenszel’s test for comparison of cohorts was used. In addition, we performed an intra-individual analysis of all parameters in 56 patients of cohort I. Findings: The prevalence of oral candidiasis, Kaposi sarcoma [KS], persistent ulcerating herpes simplex was lower than estimated, especially at CD4 counts under 200/µl. The prevalence of recurrent herpes simplex , zoster and ano-genital warts increased under HAART. With the increasing of the CD4 counts the prevalence of mollusca contagiosa and oral hairy leukoplakia decreased. On the whole the severity of HIV associated skin diseases was milder under HAART. Discussion: Our data demonstrated that HAART directly impairs the manifestation of candidiasis and KS. Our data show that the functional immune reconstitution under HAART indirectly influences the manifestation of recurrent herpes simplex , zoster and ano-genital warts. This retrospective study of 910 HIV-infected patients shows that the spectrum of HIV associated skin diseases altered under HAART. The estimation of the immune status and the life expectancy as determined by the absolute CD4-T cells in the peripheral blood and the viral load has to be re-evaluated.

Level thesis:degree_level

thesis.doctoral

Grantor dc:publisher

Ludwig-Maximilians-Universität

Year

2002

Author dc:creator

• Sammet, Stefanie

Repository record source_url

https://edoc.ub.uni-muenchen.de/666/

OAI identifier oai:identifier

oai:edoc.ub.uni-muenchen.de:666