Prevalence and risk factors for skin diseases among antiretroviral‐naïve HIV‐infected pregnant women in Dar es Salaam, Tanzania

Abstract

Background Reduced cell-mediated immunity associated with pregnancy may cause a flaring or exacerbation of some skin conditions. Little is known about the magnitude of and risk factors for skin diseases among human immunodeficiency virus (HIV)-infected antiretroviral therapy-naïve pregnant women. Methods Cross-sectional study of 1078 HIV-infected antiretroviral therapy-naïve pregnant women was conducted in Dar es Salaam, Tanzania. Skin diagnoses were mainly clinical. Log-binomial regression models were used to explore factors associated with the outcomes. Results About 84% of the women were in World Health Organization (WHO) HIV stage I. Median CD4+ count was 405 × 106 cells/l. The prevalence of any skin disease was 18%. Fungal infections (11%), genital ulcers (7%), and viral infections (5%) were the most common skin conditions. Skin infections were 2.64 times more common in HIV stage III (95% CI 1.51–4.62) compared to stage I. Fungal infections were 1.77 times common among single, divorced, and widowed women than among married women (95% CI 1.16–2.69), 2.8 times common among women in HIV stage III (95% CI 1.18–6.64) compared to stage I. Genital ulcers were significantly more common among women whose source of income was their own compared with those who got full support from partners, and among WHO HIV stage III disease compared to stage I. Conclusion The burden of skin diseases was relatively low. Advanced HIV stage was associated with a range of skin conditions. CD4+ cell count was not related to skin infection prevalence.

Burden, clinical presentation and risk factors of advanced HIV disease in pregnant Mozambican women

“…This unacceptable and constant high rate of AHD among pregnant women has important clinical and public health implications, including the strengthening of ongoing HIV-control efforts specially focused in women of childbearing age. The proportion of women with AHD in this cohort was lower than the 37% estimated in the general population in Mozambique, although this figure is from 2014 [ 8 ], and similar to reports in pregnant women from neighboring South Africa (12%) and Tanzania (12-14%) [ 13 , 38 , 39 ]. The results of this study showed that a high proportion (76.2%) of pregnant women with AHD had been on ART for a long period (nearly 2 years), suggesting suboptimal case management regarding detection of low adherence and/or treatment failure before the current pregnancy.…”