title: Skin disease: clinical indicator of immune status in human immunodeficiency virus (HIV) infection.
abstract: BACKGROUND
  Dermatological manifestations are seen at every stage of HIV/AIDS (human immunodeficiency virus), and are often the presenting features. These manifestations not only act as markers but also reflect the underlying immune status.
  
  
  OBJECTIVE
  To establish skin diseases as clinical indicators of underlying immune status in HIV disease by estimating and correlating with the CD(4), CD(4) : CD(8) ratio.
  
  
  METHODS
  The CD(4), CD(8), CD(4) : CD(8) ratios were estimated using the fluorescence activated cell sorter (FACS) count system in 20 asymptomatic HIV patients, 80 HIV patients with various skin manifestations and 72 healthy volunteers as the control group.
  
  
  RESULTS
  In comparison with the CD(4) cell count of the control group (mean 885/mm(3), standard deviation 331), that of the HIV-positive individuals (mean 409.83/mm(3), standard deviation 263.07) was statistically correlated with low counts (z = 10.099 and P < 0.05). Similarly there was statistical significance with the CD(4) : CD(8) ratio among these two groups. In comparison with the CD(4) cell count of the asymptomatic HIV-positive individuals (mean 620.65/mm(3) and standard deviation 262.065), the CD(4) cell count of the HIV-positive patients with various dermatological manifestations (mean 357.15/mm(3), standard deviation 236.95) was statistically correlated with low counts (z = 4.0978 and P < 0.05). Similarly there was statistical significance with the CD(4) : CD(8) ratio among these two groups.
  
  
  CONCLUSIONS
  There was an inverse relation between the CD(4) counts and the incidence and severity of skin diseases in the HIV/AIDS patients. Cutaneous manifestations of HIV can be considered as good clinical indicators to predict and access the underlying immune status in resource-poor countries.
authors.affiliation: Department of Dermatology, King George Hospital, Visakhapatnam, A.P., India.
authors.forename: P V Krishnam
authors.initials: PV
authors.lastname: Raju
authors.forename: G Raghurama
authors.initials: GR
authors.lastname: Rao
authors.forename: T V
authors.initials: TV
authors.lastname: Ramani
authors.forename: S
authors.initials: S
authors.lastname: Vandana
mesh_terms: D000293:Adolescent; D000328:Adult; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology; D002648:Child; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000209:etiology / Q000276:immunology*