Low CD4+ T cell counts are not risk factor for Malassezia species infection in HIV/AIDS patients
Epi Panjaitan(1*), Satiti Retno Pudjiati(2), Agnes Sri Siswati(3)
(1) Sangata District Hospital, East Kutai District, East Kalimantan Province,
(2) Department of Dermatology and Venereology, Faculty of Medicine Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta
(3) Department of Dermatology and Venereology, Faculty of Medicine Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta
(*) Corresponding Author
Abstract
cause a progressive depletion of CD4+ T cell populations accompanied by progressive impairment
of cellular immunity and increasing susceptibility to opportunistic infections. Seborrheic dermatitis
is one of the most common skin opportunistic infections on HIV/AIDS patients. Malassezia
species is bilieved as the causative of seborrheic dermatitis. The aim of the study was to evaluate
low CD4+ T cell counts as risk factor for Malassezia sp. infection in HIV/AIDS patients. This was
an observational study with cross-sectional design conducted on HIV/AIDS patients who attended
in Department of Dermatology and Venereology, Faculty of Medicine Universitas Gadjah Mada/
Dr Sardjito General Hospital, Yogyakarta and met the inclusion and exclusion criteria. Culture of
Malassezia sp. was conducted in Department of Microbiology and classified as high (>100 CFU/
tape) and low (<100 CFU/tape) density colonies. CD4+ T cell counts were measured in Department
of Clinical Pathology and classified as high (>200 cells/mm3) and low (<200 cells/mm3) CD4+ T
cell counts. A total of 83 subjects with HIV/AIDS comprising 54 (65.1%) males and 29 (34.9%)
females aged 20 - >60 years were involved in the study. The number of Malassezia sp. colony
on subjects with high and low CD4+ T cell counts were 31.55 ± 26.21 and 25.2 ± 33.89 CFU/
tape, respectively. No significantly relationship between between CD4+ T cell count and Malassezia
sp. colony number was observed in the study (p=0.607; 95%CI=0.04-5.19; RP=0.452). In
conclusion, low CD4+ T cell counts is not risk factor for Malassezia sp. infection in HIV/AIDS
patients.
Keywords
Full Text:
PDFReferences
Ramdial PK and Grayson W. Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS)-associated cutaneous diseases. In: Calonje E, Brenn T, Lazar A, McKee PH, editors. McKee's pathology of the skin. 4th eds. Philadelphia: Elsevier, 2001: 895-6. Directorate General of Communicable Diseases and Enviromental Health. Cases of HIV/AIDS in Indonesia. Jakarta: Ministry of Health, Republic of Indonesia, 2014. Okoye AA and Picker LJ. CD4+ T cell depletion in HIV infection: mechanisms of immunological failure. Immunol Rev 2013; 254(1):54-64. http://dx.doi.org/10.1111/imr.12066 Naldi L and Rebora A. Seborrheic dermatitis. N Engl J Med 2009; 360: 381-96. http://dx.doi.org/10.1056/NEJMcp0806464 Chatzikokkinou P, Sotiropoulos K, Katoulis A, Luzzati R, Trevisan G. Seborrheic dermatitis – an early and common skin manifestation in HIV patients. Acta Dermatovenerol Croat 2008; 16(4):226-30. Ashbee, HR. Recent developments in the immunology and biology of Malassezia species. FEMS Immunol Med Microbiol 2006; 47:14-23. http://dx.doi.org/10.1111/j.1574-695X.2006.00057.x Aspres N and Anderson C. Malassezia yeasts in the pathogenesis of atopic dermatitis. Aust J Dermatol 2004; 45(4):199-207. http://dx.doi.org/10.1111/j.1440-0960.2004.00097.x Lee YW, Yim SM, Lim SH, Choe YB, Ahn, KJ. Quantitative investigation on the distribution of Malassezia species on healthy human skin in Korea. Mycoses 2006; 49(5): 405–410. http://dx.doi.org/10.1111/j.1439-0507.2006.01239.x Eisenstat BA, Wormser GP. Seborrheic dermatitis and butterfly rash in AIDS. N Engl J Med 1984;311(3):189. http://dx.doi.org/10.1056/NEJM198407193110312 Blanes M, Belinchón I, Merino E, Portilla J, Sánchez-Payá J, Betlloch I. Current prevalence and characteristics of dermatoses associated with human immunodeficiency virus infection. Actas Dermosifiliogr 2010;101(8):702-9. http://dx.doi.org/10.1016/j.ad.2010.03.021 Schechtman RC, Midley G, and Hay RJ. HIV disease and Malassezia yeasts: a quantitative study of patiens presenting with seborrheic dermatitis. Br J Dermatotol 1995; 133(5): 694-8. http://dx.doi.org/10.1111/j.1365-2133.1995.tb02740.x Berger RS, Stoner MF, Hobbs ER, Hayes TJ, Boswell RN. Cutaneous manifestations of early human immunodeficiency virus exposure. J Am Acad Dermatol 1988;19(2 Pt1):298-303. http://dx.doi.org/10.1016/S0190-9622(88)70175-9 Ditjen Pengendalian Penyakit dan Penyehatan Lingkungan, Kementiran Kesehatan, Republik Indonesia. Statistik Kasus HIV/AIDS di Indonesia Dilapor s/d Desember 2012. [cited 2013 January 11]. Avaible from: www.spiritia.or.id/stats/Stat Curr.pdf Prins M, Brettle RP, Robertson JR, Aguado IH, Broers B, Carre N, et al. Geographical variation in disease progression in HIV-1 seroconverted injecting drug users in Europe. Int J Epidemiol 1999; 28: 541–549. http://dx.doi.org/10.1093/ije/28.3.541 Thakar MR, Abraham, PR, Arora S, Balakrishnan P, Bandyopadhyay B, Joshi AA. Establishment of reference CD4+ T cell values for adult Indian population. AIDS Res Ther 2011; 8:35. doi:10.1186/1742-6405-8-35 http://dx.doi.org/10.1186/1742-6405-8-35 Akinbami A, Dosunmu A, Adediran A, Ajibola S, Oshinaike O, Wright K, et al. CD4 count pattern and demographic distribution of treatment-naїve HIV patients in Lagos, Nigeria. AIDS Res Treat 2012; 2012:352753. doi:10.1155/2012/352753 http://dx.doi.org/10.1155/2012/352753 Maini MK, Gilson RJ, Chavda N, Gill S, Fakoya A, Ross EJ, et al. Reference ranges and sources of variability of CD4 counts in HIV-seronegative women and men. Genitourin Med 1996, 72(1):27-31. http://dx.doi.org/10.1136/sti.72.1.27 Sugita T, Boekhout T, Velegraki A, Guillot J, Hadina S, Cabanes FJ. Epidemiology of Malassezia-Related Skin Disease. In: Teun B, Eveline G, Peter M, Aristea V editors. Malassezia and the skin: science and clinical practice, 1st ed. Heidelberg: Springer, 2010: 65-119. http://dx.doi.org/10.1007/978-3-642-03616-3_3 Gupta AK and Bluhm R. Seborrheic dermatitis. J Eur Acad Dermatol Venereol 2004; 18(1): 13-26. http://dx.doi.org/10.1111/j.1468-3083.2004.00693.x Håkansson C, Faergemann J, Löwhagen GB. Studies on the lipophilic yeast Pityrosporum ovale in HIV-seropositive and HIV-seronegative homosexual men. Acta Derm Venerol 1988; 68(5):422-6. Munoz-Perez MA, Rodriguez-Pichardo A, Camacho F, Colmenero MA. Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 year study of 1161 patients with human immunodeficiency virus disease predominantly acquired through intravenousdrug abuse. Br J Dermatol 1998; 139:33–39. http://dx.doi.org/10.1046/j.1365-2133.1998.02310.x Farrokh R, Ghaderi E, Moradi G, Mafakheri L. The relationship between skin manifestations and CD4 counts among HIV-positive patients. Park J Med Sci 2008; 24(1):114-7. Schechtman RC, Midgley G, Hay RJ. HIV disease and Malassezia yeasts: a quantitative study of patients presenting with seborrhoeic dermatitis. Br J Dermatol 1995; 133(5):694-8. http://dx.doi.org/10.1111/j.1365-2133.1995.tb02740.x Nnoruka EN, Chukwuka JC, Anisuiba B. Correlation of mucocutaneous manifestations of HIV/AIDS infection with CD4 counts and disease progression. Int J Dermatol 2007; 46(Suppl2):14-8. http://dx.doi.org/10.1111/j.1365-4632.2007.03349.x Jagielski T, Rup E, Ziółkowska A, Roeske K, Macura AB, Bielecki J. Distribution of Malassezia species on the skin of patients with atopic dermatitis, psoriasis, and healthy volunteers assessed by conventional and molecular identification methods. BMC Dermatol 2014; 14:3. doi:10.1186/1471-5945-14-3 http://dx.doi.org/10.1186/1471-5945-14-3
DOI: https://doi.org/10.19106/JMedScie004604201401
Article Metrics
Abstract views : 2221 | views : 2567Copyright (c) 2015 Epi Panjaitan, Satiti Retno Pudjiati, Agnes Sri Siswati
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.