Significance of concomitant infectious skin manifestations and systemic immune inflammation in patients with atopic dermatitis with HIV infection
Authors:   Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russian Federation, Evdokimov E.Yu. , Ponezheva J.B. ,   Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russian Federation, Gorelova E.A. ,   Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russian Federation
Published: January 2025

Background: infectious agents play a crucial role in the pathogenesis of atopic dermatitis (AD) and are significant contributors to the
progression of the atopic march. In patients with HIV infection, impaired skin barrier function predisposes them to the development of
severe infectious complications. The impact of these factors on patient health can be objectively measured by evaluating the prevalence of
concomitant infectious skin manifestations and analyzing the systemic immune-inflammation index (SII).
Aim: this study aims to investigate the association between the severity of AD in HIV-infected patients, the frequency of concomitant infectious
skin manifestations, and levels of SII
Patients and Methods: a total of 200 patients diagnosed with AD were included in the study. Group I comprised HIV-infected patients with
AD (n=100), while group II included AD patients without HIV infection (n=100). The severity of AD was assessed in all patients alongside
the prevalence of concomitant infectious skin manifestations. Complete blood counts, including absolute values of platelets, neutrophils, and
lymphocytes, were obtained, and the SII was calculated. In group I, further analyses were conducted to examine the dependence of these
parameters on HIV stage, viral load, and CD4+ lymphocyte count.
Results: an association between the progression of HIV and the severity of AD was observed, with severe forms of AD becoming more
prevalent as the number of CD4+ lymphocytes declined and HIV stage advanced. A statistically significant increase in the frequency of
concomitant infectious skin manifestations — particularly mixed infections — was noted with increasing AD severity in both group I (p<0.05) and group II (p<0.01). SII levels rose proportionally with the severity of AD in both groups. Among HIV-infected patients (group I), SII values
escalated with advancing HIV stage and declining CD4+ lymphocyte counts.
Conclusion: the likelihood of encountering mixed forms of infectious skin manifestations increases as AD severity escalates and HIV infection
advances. This is further compounded by a reduction in CD4+ lymphocyte count, emphasizing the interconnected association between immune
dysfunction, infectious complications, and SII. These findings highlight the importance of systematic monitoring and careful treatment tactics
for HIV-infected patients with AD to improve outcomes in this vulnerable population.
KEYWORDS: atopic dermatitis, pathogenesis, infectious complications, HIV infection, index of systemic immune inflammation, concomitant
infectious skin lesions.
FOR CITATION: Evdokimov E.Yu., Ponezheva J.B., Gorelova E.A. Significance of concomitant infectious skin manifestations and systemic
immune inflammation in patients with atopic dermatitis with HIV infection. Russian Medical Inquiry. 2024;8(11):619–623 (in Russ.). DOI: 10.32364/2587-6821-2024-8-11-3