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

dc.contributor.author

Mavura, Daudi R

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Masenga, E John

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Minja, Eli

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Grossmann, Henning

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Crump, John A

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Bartlett, John A

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England

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2017-03-02T19:06:46Z

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2017-03-02T19:06:46Z

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2015-01

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.identifier

https://www.ncbi.nlm.nih.gov/pubmed/25256912

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1365-4632

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https://hdl.handle.net/10161/13770

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eng

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Wiley

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Int J Dermatol

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10.1111/ijd.12563

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Adolescent

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Adult

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Aged

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Anti-HIV Agents

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CD4 Lymphocyte Count

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Female

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HIV

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HIV Infections

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Humans

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Lamivudine

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Male

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Middle Aged

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Nevirapine

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Prospective Studies

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RNA, Viral

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Severity of Illness Index

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Skin Diseases

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Stavudine

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Tanzania

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Young Adult

dc.title

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

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Journal article

duke.contributor.orcid

Crump, John A|0000-0002-4529-102X

pubs.author-url

https://www.ncbi.nlm.nih.gov/pubmed/25256912

pubs.begin-page

68

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73

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1

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Clinical Science Departments

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Duke

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Duke Cancer Institute

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Duke Science & Society

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Global Health Institute

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Initiatives

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Institutes and Centers

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Institutes and Provost's Academic Units

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Medicine

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Medicine, Infectious Diseases

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Pathology

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School of Medicine

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School of Nursing

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School of Nursing - Secondary Group

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University Institutes and Centers

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Published

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54

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