Auswirkungen und Veränderungen bei HIV-assoziierten Hauterkrankungen durch HAART (Highly Active Antiretroviral Therapy)
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vor 21 Jahren
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.
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.
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