PROF. SINEI SAMUEL K.
(MBChB;Master of Medicine(Obstetrics & Gynaecology, M.Med O.G)
sksinei@uonbi.ac.ke
sksinei@uonbi.ac.ke
Cohen CR, Sinei S, Reilly M, Bukusi E, Eschenbach D, Holmes KK, Ndinya-Achola JO, Bwayo J, Grieco V, Stamm W, Karanja J, Kreiss J. Department of Obstetrics and Gynecology, University of Washington, Seattle, USA. crohen@u.washington.edu 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. PMID: 9780255 [PubMed - indexed for MEDLINE]
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