Molluscum contagiosum could become an early sign of HIV infection


  • Ni Luh Raka M. Hardiani Department of Internal Medicine, Wangaya General Hospital Denpasar, Bali, Indonesia
  • Ketut Suryana Department of Internal Medicine, Wangaya General Hospital Denpasar, Bali, Indonesia
  • Kadek A. Suhardinatha Department of Pathological Anatomy, Wangaya General Hospital Denpasar, Bali, Indonesia



HIV, Molluscum contagiosum, Immunocompromised


HIV is a type of virus that attack the immune system, causing it unable to function normally and putting the person in a condition called immunocompromised and is vulnerable to lots of infection. People living with HIV are prone to complications if there is persisting infection and inflammation. One of the inflammation markers is the neutrophil-lymphocyte ratio (NLR). Complication on the skin is one of the frequently happened. One of it is Molluscum contagiosum. Molluscum contagiosum caused by virus infection which target the epidermal layer of the skin that result in formation of round, umbilicated, painless papule or nodule. In this case report, we present a male, 49 years old which has complained of persistent fatigue and diarrhea. There is multiple rounds, skin-colored, painless papules on his face and neck since 6 month ago which keep increasing. Laboratory result show decrease in hemoglobin and high neutrophil lymphocyte ratio. In HIV, the NLR value has a significant negative correlation with the CD4 amount. The existence of molluscum contagiosum in an adult with unknown HIV status need to be considered as a possibility of an immunocompromised especially if accompanied with other conditions. In the patient with HIV, with the existence of Molluscum contagiosum, the possibility of decreasing CD4 and increasing viral load need to be suspected. The patient’s obedience in consuming ARV also needs a careful attention.

References 2022. Global Statistics. Available at:,54%25%20were%20women%20and%20girls. Accessed on 22 August 2022.

Riono P, Challacombe S. HIV in Indonesia and in neighbouring countries and its social impact. Oral Dis. 2020;26(S1):28-33.

Tyring S. Molluscum contagiosum: the importance of early diagnosis and treatment. Am J Obstetr Gynecol. 2003;189(3):S12-6.

Simon V, Ho D, Abdool Karim Q. HIV/AIDS epidemiology, pathogenesis, prevention, and treatment. The Lancet. 2006;368(9534):489-504.

Handayani K, Katu S, Bakri S, Halim R, Makbul Aman A, Rasyid H et al. Correlation of CD4 Count andNeutrophilLymphocyte Ratio in Human Immunodeficiency Virus-Acquired-Immunodeficiency Syndrome (HIVAIDS)Patients. Eur J Molecular Clin Med. 2020;07(08):985-33.

Raffetti E, Donato F, Casari S, Castelnuovo F, Sighinolfi L, Bandera A et al. Systemic inflammation-based scores and mortality for all causes in HIV-infected patients: a MASTER cohort study. BMC Infect Dis. 2017;17(1).

CHU C, SELWYN P. Complications of HIV Infection: A Systems-Based Approach. Am Family Physician. 2011;83(4).

Gur I. The epidemiology of Molluscum contagiosum in HIV-seropositive patients: a unique entity or insignificant finding? Int J STD amp AIDS. 2008;19(8):503-6.

Schwartz J, Myskowski P. Molluscum contagiosum in patients with human immunodeficiency virus infection. J Am Academy of Dermatol. 1992;27(4):583-8.

Cao G, Wang Y, Wu Y, Jing W, Liu J, Liu M. Prevalence of anemia among people living with HIV: A systematic review and meta-analysis. E-Clin Med. 2022;44:101283.

Franceschini N, Napravnik S, Eron J, Szczech L, Finn W. Incidence and etiology of acute renal failure among ambulatory HIV-infected patients. Kidney Int. 2005;67(4):1526-31.

Indayanie N, Rachmawati B. Packed red cell dengan delta Hb dan jumlah eritrosit anemia penyakit kronis (packed red cells with delta Hb and erythrocytes in anemia of chronic disease). Indon J Clin Pathol Med Lab. 2018;21(3):220.






Case Reports