The prevalence and spectrum of mucocutaneous disease in South African people living with HIV and accessing care at a district-level hospital

Saskya Claasens; Susanna M H Kannenberg; Henry F Jordaan; Karis Moxley; Rhodine Smith; Johann de Wet; Willem I Visser

doi:10.4102/sajhivmed.v21i1.1154

The prevalence and spectrum of mucocutaneous disease in South African people living with HIV and accessing care at a district-level hospital

South Afr J HIV Med. 2020 Dec 10;21(1):1154. doi: 10.4102/sajhivmed.v21i1.1154. eCollection 2020.

Authors

Saskya Claasens¹, Susanna M H Kannenberg¹, Henry F Jordaan¹, Karis Moxley², Rhodine Smith^{1

3}, Johann de Wet¹, Willem I Visser¹

Affiliations

¹ Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
² Research Development and Support Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
³ Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Abstract

Background: Although the association between human immunodeficiency virus (HIV) and mucocutaneous diseases has been well studied within South African specialist centres, there is limited data from district-level hospitals. Available data may, therefore, fail to reflect the prevalence and full spectrum of dermatoses seen in people living with HIV (PLWH).

Objectives: To determine the prevalence and spectrum of dermatoses seen in PLWH.

Method: We conducted a cross-sectional, descriptive study of 970 PLWH (men and women, ≥ 18 years old) accessing care at Karl Bremer Hospital, a district-level hospital located in the Western Cape province, South Africa, between 01 September 2016 and 28 February 2017.

Results: The prevalence of mucocutaneous disease in this sample was 12.7% (95% confidence interval [CI] 0.11-0.15). Non-infectious dermatoses comprised 71.0% of the disorders. Pruritic papular eruption (20.0%) and seborrheic dermatitis (6.0%) were the most common non-infectious dermatoses. Tinea corporis (8.0%) and oral candidiasis (6.0%) were the most prevalent infectious dermatoses. There was no significant association between skin disease category (infectious or non-infectious dermatoses) and patient demographics (gender and ethnicity) or HIV-disease characteristics (CD4+ cell count, viral load and duration of antiretroviral therapy [ART]).

Conclusion: This study provides valuable scientific data on the prevalence and spectrum of mucocutaneous disease in PLWH attending a South African district-level hospital. Prospective studies conducted in other district-level centres across the country are required to determine the lifetime prevalence and spectrum of dermatoses in PLWH in the ART era.

Keywords: ART; HIV; South Africa; district-level hospitals; mucocutaneous disease.