Speciation of Fungal Dermatoses in HIV-Positive Patients: A Comparative Study of HAART-Experienced and HAART-Naive Individuals in Southern Nigeria.

Speciation of Fungal Dermatoses in HIV-Positive Patients

Abstract

Abstract
Background: Fungal dermatoses remain a significant challenge among HIV-positive individuals, particularly
in resource-limited settings. Highly active antiretroviral therapy (HAART) has transformed HIV care by
reducing opportunistic infections through improved immune response. However, the relationship between
HAART use and the prevalence, severity, and spectrum of fungal dermatoses remains inadequately
characterized, especially in sub-Saharan Africa. This study aims to compare the patterns and severity of
fungal species causing dermatoses among HAART-experienced and HAART-naive HIV-positive individuals
in Benin City, Nigeria.
Methods: This comparative cross-sectional study was conducted at the University of Benin Teaching
Hospital (UBTH) in Edo State, Nigeria, from July to October 2019. We recruited a total of 300 HIV-positive
participants, comprising 150 HAART-experienced individuals and 150 HAART-naive individuals. The
systematic random sampling technique was employed. Data collection included demographic and clinical
information; clinical examination of skin lesions, and laboratory investigation findings. We confirmed the
diagnoses using potassium hydroxide microscopy (10% for skin scrapings and 20% for hair and nail clippings)
and fungal cultures. Statistical analysis was conducted using SPSS version 25, with p-values < 0.05
considered statistically significant.
Results: The prevalence of fungal dermatoses was significantly lower in HAART-experienced individuals
(14%, 21/150) compared to HAART-naive individuals (24.6%, 37/150) (χ² = 5.47, p = 0.02). Candida albicans
was the most prevalent fungal species in both groups, and was more frequently isolated from HAART-naive
individuals. Severe fungal dermatoses were significantly more common among HAART-naive individuals
(54.1%, 20/37) compared to HAART-experienced individuals (23.8%, 5/21); (χ² = 4.99, p = 0.02. HAARTexperienced
individuals demonstrated a broader spectrum of less severe fungal dermatoses.
Conclusions: HAART-experienced individuals showed significantly reduced prevalence and severity of
fungal dermatoses, although fungal species, such as Candida albicans, persisted in both groups. These
findings show the importance of improving HAART coverage and adherence to reduce the burden of fungal
infections among HIV-positive individuals.
Keywords: Fungal dermatoses, HIV-positive, HAART-experienced, HAART-naive, Candida albicans.