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Porphyrin abnormalities in acquired immunodeficiency syndrome
W J O'Connor1, G M Murphy, C Darby
1Department of Dermatology, St James's Hospital, Dublin, Ireland.
Archives of Dermatology
|December 1, 1996
Summary
Abnormal porphyrin metabolism is common in individuals with human immunodeficiency virus (HIV) infection, often linked to hepatitis C virus coinfection. Porphyria cutanea tarda should prompt testing for HIV and hepatitis C.
Area of Science:
- Medical Research
- Hepatology
- Infectious Diseases
Background:
- Porphyrin metabolism alterations are not well-characterized in human immunodeficiency virus (HIV)-positive populations.
- Understanding these metabolic changes is crucial for managing coinfections and potential dermatological manifestations.
Purpose of the Study:
- To prospectively investigate porphyrin metabolism in a cohort of HIV-positive individuals.
- To identify correlations between porphyrin excretion patterns, HIV status, and coinfections like hepatitis C virus (HCV).
Main Methods:
- Prospective study of 33 HIV-positive patients (28 men, 5 women) aged 18-35.
- Analysis of plasma, urine, and stool porphyrin excretion patterns.
- Patients were matched based on normal or abnormal porphyrin study results.
Main Results:
- 40% of patients exhibited increased urinary porphyrin excretion, predominantly those coinfected with HCV.
- 12% showed porphyrin excretion patterns characteristic of porphyria cutanea tarda, all of whom were HCV-positive.
- Increased porphyrinuria correlated with greater immunosuppression and zidovudine use.
Conclusions:
- Abnormal porphyrin metabolism is prevalent in established HIV infection, with HCV potentially contributing.
- Porphyria cutanea tarda findings in young patients warrant investigation for underlying HIV and HCV.
- Dermatologists should consider infectious risks and recommend porphyrin studies for HIV patients with photosensitivity.