Dermatological manifestation of HIV infection: systematic review and meta-analysis

Since its discovery in 1981, AIDS has become a significant global public health issue, impacting more than 38 million people worldwide with HIV. Despite a 32% reduction in new HIV infections since 2010, millions continue to be affected, often experiencing dermatological problems. This study aims to examine the epidemiology of these dermatological issues in HIV patients by reviewing existing research.

We conducted an extensive search across MEDLINE, Web of Science, Google Scholar, and grey literature, encompassing all languages and publications from 1975 to November 30, 2022. Various study designs were considered. To assess article quality, we used a risk bias instrument by JBI, performed meta-analysis and regression analysis to explore relationships between dermatological manifestations and factors such as age and region. Articles underwent double-blind review, with discrepancies resolved by a third reviewer to ensure precision and consistency.

The analysis of 145 articles involving 41,285 HIV patients identified approximately 28,448 cases of patients with dermatological diseases. Most patients had a single dermatological disease, and the majority were male adults. Research was concentrated in South Asia, North America, Western Europe, and West Africa. The most prevalent dermatological issues among 60,064 events were oral candidiasis (8.88%), dermatophytosis, seborrheic dermatitis, warts, and herpes zoster. The meta-analysis revealed an overall prevalence of 76% (95% CI: 72% - 81%) with significant heterogeneity (I² = 97%). Limitations included small sample sizes, insufficient study setting descriptions, and challenges in HIV and dermatological disease diagnosis.

This study highlights the high prevalence of dermatological diseases in HIV patients, especially oral candidiasis, dermatophytosis, and seborrheic dermatitis, with a focus on male adults as the most affected demographic group.