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Initiation of antiretroviral therapy in HIV-infected adults with skin complaints in northern Tanzania.

dc.contributor.author Mavura, Daudi R
dc.contributor.author Masenga, E John
dc.contributor.author Minja, Eli
dc.contributor.author Grossmann, Henning
dc.contributor.author Crump, John A
dc.contributor.author Bartlett, John A
dc.coverage.spatial England
dc.date.accessioned 2017-03-02T19:06:46Z
dc.date.available 2017-03-02T19:06:46Z
dc.date.issued 2015-01
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/25256912
dc.identifier.uri https://hdl.handle.net/10161/13770
dc.description.abstract Abnormal skin findings are identified in over 90% of human immunodeficiency virus (HIV)-infected persons globally. A prospective cohort study of HIV-infected patients with skin complaints commencing antiretroviral therapy (ART) in northern Tanzania was undertaken. Consecutive HIV-infected subjects presenting with skin complaints, who met criteria for ART initiation, were recruited at a Tanzanian Regional Dermatology Training Center. A single dermatologist evaluated all subjects; baseline skin biopsies were performed, and CD4(+) cell counts and plasma HIV RNA levels were measured. All subjects received a fixed-dose combination of stavudine, lamivudine, and nevirapine. A total of 100 subjects were enrolled; 86 subjects completed six months of follow-up. Median baseline CD4(+) cell counts and plasma HIV RNA levels were 120 cells/μl and 5.2 log10 copies/ml. The most common dermatologic condition was papular pruritic eruption (47%). The median baseline score on the Burn Scale was 38%. After six months, 10 subjects had achieved the complete resolution of skin abnormalities. In those without complete resolution, the median Burn Scale score improved to 7%. Five patients developed new eruptions by month 3, which in two cases were attributed to drug reactions. In the 86 subjects remaining on ART after six months, the median CD4(+) cell count had increased to 474 cells/μl, and plasma HIV RNA levels were <400 copies/ml in 85 (99%) subjects. Patients with HIV infection with skin complaints experienced marked clinical improvements following ART initiation.
dc.language eng
dc.publisher Wiley
dc.relation.ispartof Int J Dermatol
dc.relation.isversionof 10.1111/ijd.12563
dc.subject Adolescent
dc.subject Adult
dc.subject Aged
dc.subject Anti-HIV Agents
dc.subject CD4 Lymphocyte Count
dc.subject Female
dc.subject HIV
dc.subject HIV Infections
dc.subject Humans
dc.subject Lamivudine
dc.subject Male
dc.subject Middle Aged
dc.subject Nevirapine
dc.subject Prospective Studies
dc.subject RNA, Viral
dc.subject Severity of Illness Index
dc.subject Skin Diseases
dc.subject Stavudine
dc.subject Tanzania
dc.subject Young Adult
dc.title Initiation of antiretroviral therapy in HIV-infected adults with skin complaints in northern Tanzania.
dc.type Journal article
duke.contributor.id Crump, John A|0231646
duke.contributor.id Bartlett, John A|0058484
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/25256912
pubs.begin-page 68
pubs.end-page 73
pubs.issue 1
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Cancer Institute
pubs.organisational-group Duke Science & Society
pubs.organisational-group Global Health Institute
pubs.organisational-group Initiatives
pubs.organisational-group Institutes and Centers
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Infectious Diseases
pubs.organisational-group Pathology
pubs.organisational-group School of Medicine
pubs.organisational-group School of Nursing
pubs.organisational-group School of Nursing - Secondary Group
pubs.organisational-group University Institutes and Centers
pubs.publication-status Published
pubs.volume 54
dc.identifier.eissn 1365-4632


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