Correlation between CD4 cell counts with mucocutaneous manifestations: study of HIV patients in Dr. Sardjito General Hospital, Yogyakarta

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/mm 3 and the lowest was 1 cell/mm 3 . 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/mm 3 ) increases the risk of fungal infection as much as 3.8 times. Higher CD4 cell counts (>200 cells/mm 3 ) increases the risk of viral infection by about 2.5 times and parasitic infections as much as 5 times. ABSTRAKKelainan mukokutan sering dialami pasien HIV dengan morbiditas yang bervariasi. Progresitas HIV ditandai dengan penurunan angka CD4 dan munculnya manifestasi mukokutan. Penelitian ini bertujuan untuk mengkaji hubungan antara angka CD4 dengan manifestasi mukokutan pada pasien HIV. Penelitian dengan rancangan potong lintang ini dilakukan dengan mengambil data dari rekam medis di RSUP Dr. Sardjito, Yogyakarta selama periode Januari 2011-Desember 2015. Data umur pasien, jenis kelamin, faktor risiko penularan, manifestasi mukokutan paling sering terjadi dan angka CD4 dikumpulkan. 43 Satiti Retno Pudjiati et al., Correlation between CD4 cell counts with mucocutaneous manifestations: study of HIV patients in Dr. Sardjito General Hospital, YogyakartaHubungan antara angka CD4 dan manifestasi mukokutan dianalisis dengan uji chi square. Total 928 pasien terlibat dalam penelitian. Lebih setengah pasien adalah pria (65,4%) dan sebagian besar berumur antara 20-29 tahun (38,69%). Faktor risiko utama penularan HIV ...