The burden of mucocutaneous conditions and the association with HIV-1 infection in a rural community in Uganda

OBJECTIVE To determine the prevalence of mucocutaneous conditions and their association with HIV-1 infection in a rural community in Uganda. METHODS In a prospective cohort study, participants were recruited from a l arge population study and invited to attend a clinic every 3 months for a d etailed medical interview and a thorough physical examination. All findings including mucocutaneous findings were coded onto a standard questionnaire. RESULTS By the end of 1996, 436 participants had provided 1450 person years of observation (pyo); 646 pyo in HIV-positives and 804 pyo in HIV-negative s. Overall, 70% of participants had a skin condition during follow-up, and although skin conditions were Significantly more common in HIV-positive sub jects, the background level in HIV-negative subjects was high (77.3% and 63 .6%, respectively). Herpes tester, thin/sparse hair, maculo-papular rash an d prurigo were significantly more common in the HIV-positives. Kaposi sarco ma, palmar/plantar rash and herpes tester had positive predictive values fo r HIV infection of over 80%. Oral conditions were found in over 40% of part icipants and were significantly more common in HIV-positive subjects. Oral candidiasis and Kaposi sarcoma were significantly more frequent among HIV-p ositives. CONCLUSION HIV infection increases the already high burden of mucocutaneous diseases in this rural population. We identified some conditions that are more common in HIV and others that can be used as indicators of HIV infecti on.