Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global Scale

Background. Skin diseases associated with Human Immunodeficiency Virus (HIV) infection are associated with significant morbidity and mortality. In resource-limited settings, nondermatologists and lay health care providers on the front line of HIV care provide much of the treatment for these conditio...

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Main Authors: Suchismita Paul, Rachel Evans, Toby Maurer, Lulu M. Muhe, Esther E. Freeman
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:AIDS Research and Treatment
Online Access:http://dx.doi.org/10.1155/2016/3272483
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author Suchismita Paul
Rachel Evans
Toby Maurer
Lulu M. Muhe
Esther E. Freeman
author_facet Suchismita Paul
Rachel Evans
Toby Maurer
Lulu M. Muhe
Esther E. Freeman
author_sort Suchismita Paul
collection DOAJ
description Background. Skin diseases associated with Human Immunodeficiency Virus (HIV) infection are associated with significant morbidity and mortality. In resource-limited settings, nondermatologists and lay health care providers on the front line of HIV care provide much of the treatment for these conditions. Objective. To evaluate guidelines for treatment of HIV-related skin conditions and assess their accessibility, comprehensiveness, and quality of evidence employed. Methods. A review was undertaken of all national and society guidelines which included treatment information on the ten highest burden HIV-related skin conditions. The search strategy included gray and peer-reviewed literature. Results. Of 430 potential guidelines, 86 met inclusion criteria, and only 2 were written specifically to address HIV-related skin diseases as a whole. Treatment information for HIV-related skin conditions was embedded within guidelines written for other purposes, primarily HIV/AIDs treatment guidelines (49%). Development of guidelines relied either partially or completely on expert opinion (62%). Only 16% of guidelines used gradation of evidence quality and these were primarily from high-income countries (p=0.001). Limitations. Due to the nature of gray literature, not all guidelines may have been identified. Conclusion. This review highlights the need for evidence-based summary guidelines that address treatment for HIV-related skin conditions in an accessible format.
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spelling doaj-art-0cdebac06739442e8ae6cd64115b87a12025-08-20T03:54:15ZengWileyAIDS Research and Treatment2090-12402090-12592016-01-01201610.1155/2016/32724833272483Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global ScaleSuchismita Paul0Rachel Evans1Toby Maurer2Lulu M. Muhe3Esther E. Freeman4Harvard Medical School, Boston, MA, USAHIV Department, World Health Organization, Geneva, SwitzerlandDepartment of Dermatology, University of California San Francisco School of Medicine, San Francisco, CA, USADepartment of Maternal, Child and Adolescent Health, World Health Organization, Geneva, SwitzerlandDepartment of Dermatology, Massachusetts General Hospital, Harvard Medical School, Bartlett Hall 6R, 55 Fruit Street, Boston, MA 02114, USABackground. Skin diseases associated with Human Immunodeficiency Virus (HIV) infection are associated with significant morbidity and mortality. In resource-limited settings, nondermatologists and lay health care providers on the front line of HIV care provide much of the treatment for these conditions. Objective. To evaluate guidelines for treatment of HIV-related skin conditions and assess their accessibility, comprehensiveness, and quality of evidence employed. Methods. A review was undertaken of all national and society guidelines which included treatment information on the ten highest burden HIV-related skin conditions. The search strategy included gray and peer-reviewed literature. Results. Of 430 potential guidelines, 86 met inclusion criteria, and only 2 were written specifically to address HIV-related skin diseases as a whole. Treatment information for HIV-related skin conditions was embedded within guidelines written for other purposes, primarily HIV/AIDs treatment guidelines (49%). Development of guidelines relied either partially or completely on expert opinion (62%). Only 16% of guidelines used gradation of evidence quality and these were primarily from high-income countries (p=0.001). Limitations. Due to the nature of gray literature, not all guidelines may have been identified. Conclusion. This review highlights the need for evidence-based summary guidelines that address treatment for HIV-related skin conditions in an accessible format.http://dx.doi.org/10.1155/2016/3272483
spellingShingle Suchismita Paul
Rachel Evans
Toby Maurer
Lulu M. Muhe
Esther E. Freeman
Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global Scale
AIDS Research and Treatment
title Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global Scale
title_full Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global Scale
title_fullStr Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global Scale
title_full_unstemmed Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global Scale
title_short Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global Scale
title_sort treatment of dermatological conditions associated with hiv aids the scarcity of guidance on a global scale
url http://dx.doi.org/10.1155/2016/3272483
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