Satiti Retno Pudjiati
* Corresponding Author Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta Indonesia
Nadia Akita Dewi Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
Sekar Sari Arum Palupi Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
Satiti Retno Pudjiati(1*), Nadia Akita Dewi(2), Sekar Sari Arum Palupi(3)
(1) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta (2) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta (3) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta (*) Corresponding Author
Abstract
Mucocutaneous disorders often seen in HIV patients with varying morbidity. The HIV progression is characterized by the declining of CD4 cell counts and emergence of mucocutaneous manifestations. The aim of the study was to evaluate the relationship between CD4 cell counts with mucocutaneous manifestations in HIV patients. This was a cross-sectional study based on medical records at Dr. Sardjito General Hospital during the period January 2011-December 2015. Data of patient’s age, sex, risk factors of transmission, most mucocutaneous manifestations and CD4 cell count were gathered. The correlation between CD4 cell counts with muscocutaneous manifestations were analyzed using chi-square test. A total 928 patients were involved in the study. More than half of the patients were male (65.4%) and mostly, the patients aged 20-29 years (38.69%). The main risk factors for HIV transmission were unsafe sex (75%). The highest CD4 cell counts was 1094 cells/mm3 and the lowest was 1 cell/mm3. We found 306 cases of mucocutaneous manifestations. The most mucocutaneous manifestations was a fungal infection (40.4%) with the highest infection type was oral candidiasis(33.8%); then noninfection (28%) with the highest type was drug eruption(35.9%); and tumors(0.5%) that was only Kaposi sarcoma cases. We also found sexually transmitted infections (STIs) (18.85%) with the highest cases was condyloma acuminata (49.3%). Statistical analysis showed a significantly relationship between CD4 cell counts with a fungal infection (p <0.0001; OR= 3.8; 95% CI: 2.29 - 6.30), viral infection (p =0.0031; OR= 0.4; 95% CI: 0.24-0.74) and parasitic infection (p=0.043; OR= 0.2; 95% CI: 0.06-0.61). In conclusion, alteration in CD4 cell counts affects opportunistic infections occurence in HIV patients. Lower CD4 cell counts (<200 cells/mm3) increases the risk of fungal infection as much as 3.8 times. Higher CD4 cell counts (>200 cells/mm3) increases the risk of viral infection by about 2.5 times and parasitic infections as much as 5 times.
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