HIV感染者487例所患皮肤疾病与免疫缺陷的关系

目的分析HIV感染者皮肤表现和HIV感染所致免疫缺陷程度的相关性;发现患有两个及多个皮肤疾病的危险因素。方法对悉尼某皮肤科诊所1995～2005年的487例HIV阳性患者的病历资料进行回顾性分析,应用统计学软件对不同皮肤疾病与相关CD4计数的关系、患有两个及以上皮肤疾病的危险因素进行分析。结果487例患者中,485(99.6%)例有皮肤病的诊断,平均每例2.55个诊断。男性患者共479例。日光相关性皮肤病主要发生于CD4>400cells/μL的患者,很多感染性和炎症性皮肤病多发生于中度免疫抑制(250≤CD4≤450cells/μL),传染性软疣和嗜酸性毛囊炎见于CD4<250cells/μL的患者。CD4计数<250cells/μL和年龄≥40岁是发生2个以上皮肤病的危险因素。结论皮肤表现与HIV感染所致免疫缺陷程度密切相关。

The Relationship of Skin Diseases to the Immunosuppression in HIV 487 Cases of Positive Patients

ObjectiveTo find associations between the skin diseases seen and the degree of HIV immunosuppression;To find out the risk factors of presenting with two and more skin disorders.MethodsTo review the skin problems seen in 487 HIV-positive patients in a dermatology clinic in Sydney from 1995 to 2005 and to analysis the data statistically in order to find the associations of skin disorders and the degree of HIV-immunosuppression.ResultsCutaneous pathology was found in 485 of 487 patients (99.6%) with an average of 2.55 diagnoses per person,and 479 patients were male.Sun-related skin conditions were associated with a mild HIV immunosuppression (CD4>450 cells/μL),and some infectious and inflammatory skin diseases were associated with moderate immunodeficiency (CD4 between 250 to 450 cells/μL).Molluscum contagiosum and eosinophilic folliculitis were associated with severe immunodeficiency (CD4<250 cells/μL).A CD4 count of <250 cells/μL and age≥40 years were both found to be risk factors for presenting with two or more skin diseases per person.ConclusionAn association between the diseases and the degree of HIV-associated immunosuppression was found.