Abstract:

Chen Guanzhi *, Zhang Yang, Lu Xiaolin, Shi Peirong, Xu Guangyong, Sun Mengqi, Li Zhitao, Liu Xinqiao, Zhou Hui, Zhao Juan. *Department of Dermatology, Affiliated Hospital of Qingdao University, Qingdao 266003, China Corresponding author: Liu Xinqiao, Email: liuxinqiao@outlook.com 【Abstract】 Objective To explore the role of viral infection in the development of drug eruption in patients with HIV infection, and to evaluate the efficacy of antiviral treatment. Methods This study enrolled 87 HIV-positive patients, including 11 with and 76 without drug eruption, all of whom received highly active antiretroviral therapy （HAART）. Clinical data on, baseline CD4+ and CD8+ T cell counts and CD4/CD8 ratio in these subjects were retrospectively analyzed. Results The severity of drug eruption was mild in the 11 HIV-positive patients, with a mean latency period of （14.00 ± 8.10） （range, 8 - 34） days. Of the 11 patients with drug eruption, 7 had liver function impairment, which was not in accordance with the severity of skin lesions. Drug eruption was controlled in all the 11 patients after anti-anaphylactic treatment without withdrawal of antiviral drugs. Compared with 75 HIV-positive patients without drug eruption, the 11 HIV-positive patients with drug eruption showed significantly increased baseline CD4+ T cell counts （493.00 ± 245.68 （range, 42 － 810）/μl vs. 347.81 ± 167.00 （range, 11 － 814 ）/μl, t = 647.50, P < 0.05）, but decreased proportion of patients with baseline CD4+ T cell counts below the lower limit of normal （3/11 vs. 48/75 （64.00%）, χ2 = 3.95, P < 0.05）. There were no significant differences between 10 patients with drug eruption and 69 patients without drug eruption in the baseline CD8+ T cell count （1472.30 ± 858.55/μl vs. 1356.59 ± 684.06/μl, P > 0.05）, CD4/CD8 ratio （0.40 ± 0.27 vs. 0.29 ± 0.16, P > 0.05）, or percentage of patients with a CD4/CD8 ratio below the lower limit of normal （9/10 vs. 68/69 （98.55%）, P > 0.05）. Conclusions The latency period of drug eruption seems to be long in HIV-positive patients receiving HAART, and mild drug eruption can be complicated by liver function impairment in the patients. Relatively high CD4+ counts may be a risk factor for the development and aggravation of drug eruption in HIV-positive patients.