This article is more than 5 years old. Information may no longer be current.

Loss of CD4+ cells increases risk for toxic epidermal necrolysis in patients with HIV

Decreased dermal CD4⁺ cell counts, combined with an increased ratio of CD8⁺ to CD4⁺ cells penetrating the dermis, in patients with HIV likely increases the risk for adverse cutaneous drug eruptions like toxic epidermal necrolysis, according to recent study findings.

Researchers compared inflammatory infiltrates from 12 cases of toxic epidermal necrolysis (TEN) in HIV-positive patients with those of 12 cases found in HIV-negative patients.

An eightfold increase in the ratio of CD8⁺ to CD4⁺ cells penetrating the dermis (P = .006), as well as a significant decrease in the number of dermal CD4⁺ cells present (P = .044), was seen among patients with HIV, the researchers reported.

Additionally, there was a significant decrease in the ratio of CD25⁺ to CD4⁺ cells found in the epidermis of HIV-positive patients (P = .011).

Given that CD4⁺CD25⁺ regulatory T cells have demonstrated skin-protective qualities, the loss of these cells also likely contributes to a higher risk among patients with HIV for developing adverse cutaneous drug eruptions, according to the researchers.