A study of Mucocutaneous Manifestations of HIV infections & its relation with CD4 Count

Abstract

AIDS was first recognized in the United States in 1981. In 1983, HIV was isolated and by 1984 it was demonstrated clearly to be the causative agent of AIDS. All countries in the world are facing HIV/AIDS occurrence as a major health problem. Dermatological involvement in AIDS has been appreciated since the days the disease was recognized as a cryptic acquired immune deficiency illness in homosexual men and before the causative virus was identified. HIV has been demonstrated in the dermis of infected individuals and may be present in langerhans cells. It is estimated that more than 90% of HIV- infected patients develop skin or mucous membrane disorders at some time during their infection. The knowledge of skin manifestations such as bacillary angiomatosis, Kaposi‘s sarcoma, oral candidiasis and hairy leukoplakia, may provide a clue for diagnosing a previously undetected HIV positive status. CD4 cell count is extremely important in staging of HIV infection and a revised classification of the center for disease control (CDC), Atlanta, USA (1993) divides HIV positive persons into three CD4 count categories: 1) 1>500/Ml; 2) 200- 499/Ml, 3) Pneumocystis carinii pneumonia: In general a CD4 cell count of 200/mL is roughly equivalent to 20% of the lymphocyte count. The normal range for CD4 values vary between laboratories but they are around 500- 1300/mL for the absolute count and 38%- 65% for the percentage. The CD4 T lymphocytes; a subpopulation of the lymphocytes also known as T helper cells, are coordinators of the body‘s immune response, e.g. providing help to B cells in the production of antibody, as wells as in augmenting cellular immune response to antigens. Within hours of exposure to HIV, CD4 T lymphocytes are found to be infected showing active viral replication.