Журнал клинических и экспериментальных дерматологических исследований
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The Role of Dermatologic Manifestations as a Predictive Value on CD4 Cell Count among HIV/AIDS Patients

Jessica Lie*, Stephen Akihiro Wirya*, Yuli Kurniawati, Mohammad Izazi Hari Purwoko, Suroso Adi Nugroho, Rusmawardiana, Irsan Saleh

Introduction: Dermatologic manifestations can be seen in HIV/AIDS patients, which may worsen following the progression of HIV. This study aims to determine the role of dermatologic manifestations in predicting CD4 cell count among HIV/AIDS patients.

Methods: This was a cross-sectional observational analytic study among HIV/ AIDS patients who came to Voluntary Counselling Test (VCT) and Dermatology and Venereology (DV) outpatient clinic in Dr. Mohammad Hoesin General Hospital Palembang, South Sumatera, Indonesia, from December 2018 to March 2019. All HIV/AIDS patients' demographic data were recorded, eligible patients were screened for dermatologic manifestations and blood examination was done for CD4 cell count at the appointed laboratory. Data collected was to evaluate the type of dermatologic manifestation association with CD4 cell count and calculate Positive Predictive Value (PPV) using Chi-Square and IBM SPSS Statistics for Windows, Ver.26.

Results: A total of 70 out of 83 HIV/AIDS patients (84.3%) had at least one dermatologic manifestation. The most common dermatologic manifestation is infection (34%), of which 75% had CD4 cell count <200 cells/µL. The non-infection dermatologic manifestations are most commonly found in those with CD4 cell count 200–499 cells/ µL (57.9%). Among patients with higher CD4 cell count ≥ 500 cells/µL, there were (53.8%) with no dermatologic manifestation. There was a significant association of low CD4 cell count <200 cells/µL with increasing number and type of dermatologic manifestations with p ≤ 0.001. This study found HIV/AIDS patients with dermatologic manifestations had a 3.944 times higher chance of having a low CD4 cell count with a Prevalence Ratio (PR) of (95% CI 2.031–7.660, p ≤ 0.001). Calculation of PPV at 84.3% prevalence with 90% specificity and sensitivity shows that infection and combination dermatologic manifestations had 98.4% of having CD4 cell count <200 cells/µL.

Conclusion: Dermatologic manifestations have a predictive value on CD4 cell count in HIV/AIDS patients.