HIV-Associated Dermatological Alterations: Barrier Dysfunction, Immune Impairment, and Microbiome Changes

Area of Science:

• Dermatology
• Immunology
• Microbiology

Background:

• Human Immunodeficiency Virus (HIV) compromises the skin's barrier function and immune defenses.
• HIV infection leads to structural changes in the epidermis and adnexal structures.
• Dysregulation of the immune system and shifts in the skin microbiome are characteristic of HIV.

Purpose of the Study:

• To investigate the multifaceted impact of HIV on skin structure, immune responses, and the skin microbiome.
• To elucidate the mechanisms underlying HIV-associated dermatological conditions.
• To identify key factors influencing these alterations in HIV patients.

Main Methods:

• Analysis of epidermal and adnexal structure alterations in HIV.
• Assessment of immune system dysregulation, including CD4+ T-cell depletion and cytokine imbalances.
• Characterization of the skin microbiome composition in HIV-infected individuals.

Main Results:

• HIV causes epidermal hyperplasia and inflammatory infiltrates, affecting skin barrier integrity.
• Immune compromise in HIV patients leads to hypersensitivity and inflammatory dermatoses.
• Distinct shifts in the skin microbiome, with reduced Cutibacterium and increased opportunistic microbes, are observed in HIV patients, irrespective of CD4+ T-cell counts.

Conclusions:

• HIV significantly impacts skin health through structural, immunological, and microbiological changes.
• Factors like age, sex, and environment modulate these HIV-related skin alterations.
• Targeted therapies addressing these interconnected changes are essential for managing dermatological complications in HIV.