Drug therapy has changed HIV skin disease patterns

The skin manifestations of HIV infection have changed in the era of highly active antiretroviral therapy (HAART), the combination drug therapy introduced to combat the virus in the mid-1990s, new research shows.

Dr. Ciro R. Martins of Johns Hopkins University in Baltimore and colleagues examined the initial visits of 897 HIV patients to a dermatology clinic from 1996 to 2002 to investigate HIV-related skin complications.

Just over two thirds of the patients were African-American, and the chief means of contracting HIV was sexual contact (56 percent of patients), followed by injection drug use (43 percent). Overall, 61 percent of patients began HAART before their initial visit to the dermatology clinic, the team reports in the Journal of the American Academy of Dermatology.

Folliculitis, inflammation of the hair follicles, was the most common skin disease, affecting 18 percent of the patients. The next most common skin condition was genital warts, seen in 11.5 percent, followed by seborrheic dermatitis, irritation due to sebaceous secretions, in 10.6 percent.

Folliculitis was more common in patients with evidence of a weakened immune system. High levels of HIV were linked to itching and yeast infections.

Among patients on HAART, 6.2 percent were overly sensitive to light compared with 2.9 percent who were not taking the drugs, Martins and his colleagues found. Molluscum contagiosum, a type of viral disease of the skin, also was more common among patients on HAART, they write.

"As the treatments for HIV continue to advance, it is likely that the (skin) manifestations will also continue to evolve and further studies will be required to adequately assess their changing nature and prevalence," the investigators conclude.

SOURCE: Journal of the American Academy of Dermatology, April 2006.