HIV and skin infections.

Area of Science:

• Dermatology
• Infectious Diseases
• Immunology

Background:

• HIV infection profoundly alters the skin microbiome, leading to increased susceptibility to various cutaneous infections.
• These infections range from atypical common skin conditions to severe, AIDS-defining disseminated illnesses.
• Bacterial, mycobacterial, viral, and fungal infections are common, with some posing significant treatment challenges.

Purpose of the Study:

• To review the spectrum of cutaneous infections in individuals living with HIV.
• To highlight challenges in diagnosis and treatment, including antifungal resistance and immune reconstitution inflammatory syndrome.
• To emphasize the importance of prompt microbiological diagnosis for effective management.

Main Methods:

• Review of current literature on HIV-associated cutaneous infections.
• Discussion of common and opportunistic pathogens affecting the skin in HIV.
• Emphasis on diagnostic modalities and treatment considerations.

Main Results:

• Bacterial infections (e.g., Staphylococcus aureus) are frequent and can lead to bacteremia.
• Nontuberculous mycobacterial infections may disseminate, lacking specific treatment guidelines.
• Herpes simplex and zoster infections can be severe, requiring prompt antiviral therapy.
• Viral warts and candidiasis present treatment difficulties, with emerging antifungal resistance.
• Immune reconstitution can exacerbate existing or new cutaneous infections.

Conclusions:

• Cutaneous infections are a major concern for people living with HIV, influenced by immune status and antiretroviral therapy.
• Accurate and rapid diagnosis through direct microscopy and culture is essential for guiding treatment.
• Addressing challenges like antifungal resistance and immune reconstitution is critical for improving patient outcomes.