title: Effect of antiretroviral therapy on mucocutaneous manifestations among Human Immunodeficiency Virus-infected patients in a tertiary care centre in South India.
abstract: BACKGROUND
  Human Immunodeficiency Virus (HIV) infection produces a wide range of infectious and noninfectious dermatoses which correlate with the degree of immunodeficiency. Since the introduction of highly active antiretroviral therapy (HAART), there has been a dramatic decrease in the incidence of HIV-associated dermatoses. However, HAART itself causes various cutaneous adverse drug reactions.
  
  
  OBJECTIVE
  To assess the various mucocutaneous manifestations in HIV-infected individuals and its association with CD4 count and to assess the effect of HAART on mucocutaneous manifestations.
  
  
  METHODS
  Of the 170 patients recruited, 110 patients were previously diagnosed with HIV and were on follow-up. The rest 60 patients were newly diagnosed cases at recruitment, and these patients were followed up every month for mucocutaneous manifestations for a period of 6 months.
  
  
  RESULTS
  Of the 170 patients screened, 69.41% patients had at least one mucocutaneous lesion at presentation. Fungal, viral, and bacterial infections were observed present in 17.6%, 10.6%, and 9.4% patients, respectively. There was a significant difference in the occurrence of candidal infections in the HAART versus non-HAART group (P = 0.0002). Candidiasis (P ≤ 0.0001) and human papillomavirus infection (P = 0.0475) occurred more commonly with CD4 count <200 cells/mm (3) . Among the noninfectious dermatoses, inflammatory dermatoses (17.6%) were more commonly observed at recruitment followed by adverse cutaneous drug reactions (16.5%) and neoplasms (5.3%).
  
  
  CONCLUSIONS
  HAART has significantly altered the patterns of mucocutaneous manifestations. The prevalence of both infectious and inflammatory dermatoses has come down. However, there is an increase in the incidence of adverse cutaneous drug reactions.
authors.affiliation: Department of Dermatology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
authors.forename: Nagendran
authors.initials: N
authors.lastname: Prabhakaran
authors.affiliation: Department of Dermatology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
authors.forename: Telanseri J
authors.initials: TJ
authors.lastname: Jaisankar
authors.affiliation: Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
authors.forename: Abdoul
authors.initials: A
authors.lastname: Hamide
authors.affiliation: Department of Dermatology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
authors.forename: Munisamy
authors.initials: M
authors.lastname: Malathi
authors.affiliation: Department of Dermatology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Kumari
authors.affiliation: Department of Dermatology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
authors.forename: Devinder Mohan
authors.initials: DM
authors.lastname: Thappa
keywords: Antiretroviral therapy; CD4 count; Human Immunodeficiency Virus infection; mucocutaneous manifestations