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Ekpe O, Onunu AN, Forae GD, Okwara B. Clinicopathological Features of Pruritic Papular Eruption of HIV Patients seen in Benin-City, Nigeria. West Afr J Med 2020; 37:53-57. [PMID: 32030712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Pruritic papular eruption (PPE) is a frequent cause of substantial morbidity in Human Immunodeficiency Virus (HIV) patients in Nigeria. This skin condition remains the most common cutaneous manifestation in HIV-infected patients and it is more prevalent in developing countries. AIMS To describe the clinical and pathologic features of PPE in our patients, and compare with those seen in other parts of the world. MATERIALS AND METHODS Specimen collection, analysis and write-up of the study lasted 18 months (January 2015 to June 2016) after ethical approval of the proposal. The study design was a cross-sectional descriptive study of confirmed HIV-infected patients with clinically active PPE lesions presenting at the Dermatology outpatient clinic, the HIV/ART clinic, and those admitted as in-patients in the medical wards of the University of Benin Teaching Hospital, Benin. Data generated from the study were entered into and analyzed using the Statistical Package for the Social Sciences (SPSS) version 21. RESULTS Only 106 patients were histologically confirmed to be PPE and subsequently recruited for the study. The pattern of distribution of PPE-HIV suggested that the rash has a predilection for exposed parts of the body. The body regions most significantly affected were lateral surface of lower limb, upper limb extensor surface, dorsal surface of foot and dorsal surface of hand. The most common secondary changes observed among the patients were excoriated papules, post-inflammatory hyper- and hypopigmentation, scarring, lichenification. CONCLUSION Lesions of pruritic papular eruptions (PPE) of HIV in this study were distributed predominantly on the exposed parts of the body especially the upper and lower limbs.
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Affiliation(s)
- O Ekpe
- Department of Medicine, Federal Medical Centre Umuahia, Abia State,Nigeria
| | - A N Onunu
- Department of Medicine, University of Benin Teaching Hospital, Benin City,Nigeria
| | - G D Forae
- Department of Pathology, University of Benin Teaching Hospital, Benin City,Nigeria
| | - B Okwara
- Department of Medicine, University of Benin Teaching Hospital, Benin City,Nigeria
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Bernard C, Balestre E, Coffie PA, Eholie SP, Messou E, Kwaghe V, Okwara B, Sawadogo A, Abo Y, Dabis F, de Rekeneire N. Aging with HIV: what effect on mortality and loss to follow-up in the course of antiretroviral therapy? The IeDEA West Africa Cohort Collaboration. HIV AIDS (Auckl) 2018; 10:239-252. [PMID: 30532600 PMCID: PMC6247956 DOI: 10.2147/hiv.s172198] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Reporting mortality and lost to follow-up (LTFU) by age is essential as older HIV-positive patients might be at risk of long-term effects of living with HIV and/or taking antiretroviral therapy (ART). As age effects might not be linear and might impact HIV outcomes in the oldest more severely, people living with HIV (PLHIV) aged 50-59 years and PLHIV aged >60 years were considered separately. Setting Seventeen adult HIV/AIDS clinics spread over nine countries in West Africa. Methods Data were collected within the International Epidemiological Databases to Evaluate AIDS West Africa Collaboration. ART-naïve PLHIV-1 adults aged >16 years initiating ART and attending ≥2 clinic visits were included (N=73,525). Age was divided into five groups: 16-29/30-39/40-49/50-59/≥60 years. The age effect on mortality and LTFU was evaluated with Kaplan-Meier curves and multivariable Cox proportional hazard regressions. Results At month 36, 5.9% of the patients had died and 47.3% were LTFU. Patients aged ≥60 (N=1,736) and between 50-59 years old (N=6,792) had an increased risk of death in the first 36 months on ART (adjusted hazard ratio=1.66; 95% CI: 1.36-2.03 and adjusted hazard ratio=1.31; 95% CI: 1.15-1.49, respectively; reference: <30 years old). Patients ≥60 years old tend to be more often LTFU. Conclusion The oldest PLHIV presented the poorest outcomes, suggesting that the PLHIV aged >50 years old should not be considered as a unique group irrespective of their age. Tailored programs focusing on improving the care services for older PLHIV in Sub-Saharan Africa are clearly needed to improve basic program outcomes.
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Affiliation(s)
- Charlotte Bernard
- INSERM, Centre INSERM U1219-Epidémiologie-Biostatistique, Bordeaux, France, .,University of Bordeaux, School of Public Health (ISPED), Bordeaux, France,
| | - Eric Balestre
- INSERM, Centre INSERM U1219-Epidémiologie-Biostatistique, Bordeaux, France, .,University of Bordeaux, School of Public Health (ISPED), Bordeaux, France,
| | - Patrick A Coffie
- Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.,Unit of Infectious and Tropical Diseases, Treichville University Teaching Hospital, Abidjan, Côte d'Ivoire.,Programme PAC-CI, Treichville University Teaching Hospital, Abidjan, Ivory Coast
| | - Serge Paul Eholie
- Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.,Unit of Infectious and Tropical Diseases, Treichville University Teaching Hospital, Abidjan, Côte d'Ivoire
| | - Eugène Messou
- Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.,Unit of Infectious and Tropical Diseases, Treichville University Teaching Hospital, Abidjan, Côte d'Ivoire.,Programme PAC-CI, Treichville University Teaching Hospital, Abidjan, Ivory Coast.,Center of Care, Research and Training (CePReF), Yopougon-Attié Hospital, Abidjan, Ivory Coast
| | | | - Benson Okwara
- University of Benin City Teaching Hospital, Benin City, Nigeria
| | - Adrien Sawadogo
- Institut Supérieur des Sciences de la Santé (INSSA), Bobo-Dioulasso Polytechnic University, Bobo-Dioulasso, Burkina Faso
| | - Yao Abo
- National Blood Transfusion Center (CNTS), Abidjan, Ivory Coast
| | - François Dabis
- INSERM, Centre INSERM U1219-Epidémiologie-Biostatistique, Bordeaux, France, .,University of Bordeaux, School of Public Health (ISPED), Bordeaux, France,
| | - Nathalie de Rekeneire
- INSERM, Centre INSERM U1219-Epidémiologie-Biostatistique, Bordeaux, France, .,University of Bordeaux, School of Public Health (ISPED), Bordeaux, France,
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