Clinicopathological concordance of mucocutaneous manifestations in people living with HIV: A cross-sectional study

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES HIV Medicine Pub Date : 2024-07-08 DOI:10.1111/hiv.13686

Dalit Zajdman-Faitelson, Miren Lorea Cárdenas-Hernández, Simón Guzmán-Bucio, Antonio Camiro-Zuñiga, Maria Elisa Vega Memije

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Abstract

Objective

To describe the frequency and clinicopathological concordance of mucocutaneous manifestations in people living with HIV (PLWH) and its correlation with CD4+ T lymphocyte count and HIV viral load.

Methods

Cross-sectional study of patients diagnosed with HIV infection who underwent skin biopsy for histopathological study from 1992 to 2022. Skin diseases were categorized as opportunistic and sexually transmitted infections, inflammatory dermatoses, benign cutaneous neoplasms, and premalignant and malignant cutaneous neoplasms. Clinicopathological concordance was classified as complete, partial or discordant. Frequency of skin diseases are presented by category and according to lymphocyte CD4+ count and HIV viral load.

Results

A total of 659 patients were included of whom 88.5% (n = 583) were male. The most frequent diagnostic category was opportunistic or sexually transmitted infections in 34% (n = 224) and the most frequently found condition was Kaposi sarcoma in 17% (n = 112). Clinicopathological concordance was complete in 53.7% (n = 354) of cases, partial in 26.7% (n = 176) and discordant in 19.6% (n = 129). Among the 282 patients with available serological data, 58.9% (n = 166), 23.8% (n = 67) and 17.4% (n = 49) had CD4+ counts below 200, between 200 and 499, and above 500 cells/μl, respectively.

Conclusions

Although there is a high variability in skin conditions which people with HIV may present, there was a high rate of clinicopathological concordance (80.4%). We emphasize the importance of diagnostic skin biopsies due to their diverse morphological presentation. The frequency of skin diseases in PLWH depending on different clinical settings should aid the clinician in reaching an adequate diagnosis in this population.

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艾滋病病毒感染者粘膜表现的临床病理学一致性：一项横断面研究。

目的描述艾滋病病毒感染者（PLWH）皮肤黏膜表现的频率和临床病理学一致性，及其与 CD4+ T 淋巴细胞计数和艾滋病病毒载量的相关性：横断面研究：1992 年至 2022 年期间，对确诊感染 HIV 的患者进行皮肤活检组织病理学研究。皮肤病分为机会性感染和性传播感染、炎症性皮肤病、良性皮肤肿瘤以及恶性和恶性前皮肤肿瘤。临床病理学一致性分为完全一致、部分一致和不一致。根据淋巴细胞 CD4+ 计数和 HIV 病毒载量，按类别列出皮肤病的发病率：共纳入 659 名患者，其中 88.5%（n = 583）为男性。最常见的诊断类别是机会性感染或性传播感染，占 34%（n = 224），最常见的病症是卡波西肉瘤，占 17%（n = 112）。临床病理学完全一致的病例占 53.7%（354 例），部分一致的病例占 26.7%（176 例），不一致的病例占 19.6%（129 例）。在有血清学数据的 282 例患者中，CD4+计数低于 200、介于 200 和 499 之间以及高于 500 cells/μl 的患者分别占 58.9%（n = 166）、23.8%（n = 67）和 17.4%（n = 49）：结论：尽管艾滋病病毒感染者可能出现的皮肤病差异很大，但临床病理一致率很高（80.4%）。我们强调皮肤活检诊断的重要性，因为其形态表现多种多样。根据不同的临床环境，艾滋病病毒感染者皮肤病的发生率应有助于临床医生对这一人群做出适当的诊断。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.