Initiation of antiretroviral therapy in HIV-infected adults with skin complaints in northern Tanzania.

Published

Journal Article

Abnormal skin findings are identified in over 90% of human immunodeficiency virus (HIV)-infected persons globally. A prospective cohort study of HIV-infected patients with skin complaints commencing antiretroviral therapy (ART) in northern Tanzania was undertaken. Consecutive HIV-infected subjects presenting with skin complaints, who met criteria for ART initiation, were recruited at a Tanzanian Regional Dermatology Training Center. A single dermatologist evaluated all subjects; baseline skin biopsies were performed, and CD4(+) cell counts and plasma HIV RNA levels were measured. All subjects received a fixed-dose combination of stavudine, lamivudine, and nevirapine. A total of 100 subjects were enrolled; 86 subjects completed six months of follow-up. Median baseline CD4(+) cell counts and plasma HIV RNA levels were 120 cells/μl and 5.2 log10 copies/ml. The most common dermatologic condition was papular pruritic eruption (47%). The median baseline score on the Burn Scale was 38%. After six months, 10 subjects had achieved the complete resolution of skin abnormalities. In those without complete resolution, the median Burn Scale score improved to 7%. Five patients developed new eruptions by month 3, which in two cases were attributed to drug reactions. In the 86 subjects remaining on ART after six months, the median CD4(+) cell count had increased to 474 cells/μl, and plasma HIV RNA levels were <400 copies/ml in 85 (99%) subjects. Patients with HIV infection with skin complaints experienced marked clinical improvements following ART initiation.

Full Text

Duke Authors

Cited Authors

  • Mavura, DR; Masenga, EJ; Minja, E; Grossmann, H; Crump, JA; Bartlett, JA

Published Date

  • January 2015

Published In

Volume / Issue

  • 54 / 1

Start / End Page

  • 68 - 73

PubMed ID

  • 25256912

Pubmed Central ID

  • 25256912

Electronic International Standard Serial Number (EISSN)

  • 1365-4632

Digital Object Identifier (DOI)

  • 10.1111/ijd.12563

Language

  • eng

Conference Location

  • England