AEGiS-11IAC: HIV and acute pelvic inflammatory disease: a laparoscopic study in Kenya.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

HIV and acute pelvic inflammatory disease: a laparoscopic study in Kenya.

Int Conf AIDS 1996 Jul 7-12; 11:219 (abstract no. Th.B.113)
Cohen C, Sinei S, Reilly M, Stamm W, Eschenbach D, Holmes K, Ndinya-Achola JO, Karanja J, Kreiss J; Medical Microbiology Annexe, Nairobi, Kenya. Fax: 254-2-712007.

INTRODUCTION: This study was undertaken in order to determine the effect of HIV infection upon PID, the microbiologic etiology of PID, and the accuracy of the WHO clinical criteria for PID using diagnostic laparoscopy as the gold standard.

METHODS: Patients who met the WHO clinical criteria for acute PID at Kenyatta National Hospital were recruited. Subjects underwent an interview, and physical examination, after which diagnostic laparoscopy was performed. Laboratory investigations included HIV and STD screening.

RESULTS: 115 patients with a clinical diagnosis of acute PID were enrolled. Among them, 106 (92%) had laparoscopically verified PID (22% mild, 38% moderate, 40% severe by laparoscopic criteria). Culture for gonorrhea was positive in 21 (20%), and chlamydia by either antigen detection or culture was positive in 8/67 (12%). Forty-four (42%) were HIV seropositive. HIV seropositive and seronegative subjects were similar in age (27.3 vs. 25.7 years, p=17) and marital status (50% vs. 44% married, p=.51). No significant difference was detected between HIV seropositive and seronegative patients for duration of abdominal pain (9.3 vs. 7.5 days, p=.16), clinical severity score (18 vs. 17, p=.55), gonorrhea (16% vs. 23%, p=.38), or chlamydia (14% vs. 11%, p=.68). HIV seropositive patients were significantly more likely than HIV seronegative patients to have a tubo-ovarian abscess (36% vs. 18%, OR 1.6, 95% CI 1.0 - 2.6). Among HIV seropositive patients CD4 depletion was not significantly associated with tubo-ovarian abscesses (mean CD4 count 301 among TOA present vs. 385 among TOA absent, p=.25). HIV seropositive and seronegative patients required similar lengths of hospitalization (6.4 vs. 5.3 days, p=.22).

CONCLUSIONS: Among patients with laparoscopically verified PID, HIV infection is associated with tubo-ovarian abscesses. However, the duration of hospitalization did not differ by HIV serostatus.

Keywords: AEGIS, HIV Infections, HIV Seropositivity, Chlamydia Infections, Fallopian Tube Diseases, Gonorrhea, Ovarian Diseases, CD4 Lymphocyte Count, Laparoscopy, Abscess, Kenya, Female, Human, ICA11

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