HIV感染者487例所患皮肤疾病与免疫缺陷的关系

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

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。

Objective To 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. Methods To 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. Results Cutaneous 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. Conclusion An association between the diseases and the degree of HIV-associated immunosuppression was found.