Skin Manifestations of HIV Infection in Children in Pediatric Services of Conakry University Hospital (Guinea)

Abstract

Introduction : Dermatological manifestations during HIV infection play a diagnostic and prognostic role. They are observed in 83 % - 98% of patients at the late stage of AIDS and 58 % - 75% at an early stage of AIDS. The objective of this study was to determine the prevalence of skin diseases in HIV in children, describe s the demographic profile and identify key dermatoses. Material and methods : This was a prospective study of descriptive kind conducted from August 25, 2009 to February 25, 2010. It involved children infected with HIV followed in pediatric services at the University Hospital of Conakry. All children were examined by an experienced dermatologist. The diagnosis of dermatosis was made according to the clinical signs. The stages of HIV infection were determined according to the WHO classification. Each child received retroviral serology rapid tests according to national algorithm. Results : Among 119 HIV-positive children 65 showed mucocutaneous manifestations, there are 34 girls and 31 boys, all HIV-1 infected with 66.16% in stage III disease. The average age was 7 years, ranging from 11 months to 15 years. 66.15% of the children were from married mothers and more than half of the mothers were illiterate. They were all positive for HIV1. Oral candidiasis (38.46%), prurigo (29.23%) and molluscum contagiosum (7.69%) were the most common skin diseases; 52.31% had at least two associated dermatoses. The candidiasis-prurigo combination (26.47%) was the most common. Dermatosis was often associated with other conditions: malaria (30.76%), pulmonary tuberculosis (25.61%) and malnutrition (12.30%). Discussion : With 65 cases diagnosed in six months our study shows that skin diseases are common in HIV among children in Guinea. The prevalence and socio-demographic characteristics are close to those reported by sub saharian and North African authors. A special feature of the study is that most mothers are illiterate and are infected with HIV, which would have favored the contamination of these children. Conclusion : In Sub-Saharan Africa where the rate of pediatric HIV infection is increasing, it is important to identify the mucocutaneous manifestations for optimal care.