Effect of human immunodeficiency virus type 1 infection upon acute salpingitis: a laparoscopic study.
To determine the effect of human immunodeficiency virus type 1 (HIV-1) infection upon pelvic inflammatory disease (PID), a laparoscopic study of acute PID was conducted in Nairobi, Kenya. Subjects underwent diagnostic laparoscopy, HIV-1 serology, and testing for sexually transmitted diseases. Of the 133 women with laparoscopically verified salpingitis, 52 (39%) were HIV-1-seropositive. Tubo-ovarian abscesses (TOA) were found in 33% of HIV-1-infected and 15% of HIV-1-uninfected women (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.2-6.5). Among seropositive women, TOA was found in 55% of those with CD4 cell percent <14% vs. 28% with CD4 cell percent>14% (OR 3.1, 95% CI 0.6-15.3). Neisseria gonorrhoeae was detected in 37 women (28%) and Chlamydia trachomatis in 12 (9%); neither was significantly related to HIV-1 seropositivity. Length of hospitalization was not affected by HIV-1 serostatus overall but was prolonged among HIV-1-infected women with CD4 cell percent <14%. Among patients with acute salpingitis, likelihood of TOA was related to HIV-1 infection and advanced immunosuppression. In general, HIV-1-seropositive women with acute salpingitis responded well to treatment.
Department of Obstetrics and Gynecology, University of Washington, Seattle, USA. crohen@u.washington.edu
C R
CR
Cohen
S
S
Sinei
M
M
Reilly
E
E
Bukusi
D
D
Eschenbach
K K
KK
Holmes
J O
JO
Ndinya-Achola
J
J
Bwayo
V
V
Grieco
W
W
Stamm
J
J
Karanja
J
J
Kreiss
D000038:Abscess / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000150:complications / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005184:Fallopian Tube Diseases / Q000453:epidemiology; D005260:Female; D006069:Gonorrhea / Q000150:complications / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D018023:HIV Seronegativity; D015528:HIV Seroprevalence; D015497:HIV-1; D006760:Hospitalization; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D010535:Laparoscopy; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D010049:Ovarian Diseases / Q000453:epidemiology; D015995:Prevalence; D012488:Salpingitis / Q000150:complications* / Q000453:epidemiology