Document 1164
 DOCN  M94A1164
 TI    HIV infection is associated with more severe clinical presentation of
       PID.
 DT    9412
 AU    Munkolenkole K; De Cock KM; St Louis M; Ghys P; Toure CK; Kreiss J;
       Projet Retro-CI, Abidjan, Cote d'Ivoire.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):194 (abstract no. PB0788). Unique
       Identifier : AIDSLINE ICA10/94371411
 AB    OBJECTIVE: To assess the impact of human immunodeficiency virus (HIV)
       infection on pelvic inflammatory disease (PID). METHODS: Case-control
       study of 57 HIV seropositive and 113 HIV seronegative women with PID at
       a university hospital and 4 primary care clinics in Abidjan, Cote
       d'Ivoire. Women underwent questionnaire, physical examination, pelvic
       ultrasonography, and laboratory testing. RESULTS: At presentation,
       HIV(+) women were more likely than HIV(-) women to report fever (72% vs
       58%, p = 0.08) and vaginal discharge (86% vs 74%, p = 0.06).
       Seropositive women more often had oral temperature > or = 38 degrees C
       (OR 2.5; CI 1.0, 6.4), genital ulcer (OR 7.8; CI 1.8, 45.4), and
       tuboovarian mass (TOM) on transabdominal ultrasonography (OR 2.6; CI
       1.1, 6.4). HIV(+) women were more likely to require surgery (OR 6.5; CI
       1.1, 67.5) and hospitalization (OR 3.5; CI 0.9, 14.3). The mean clinical
       severity score was significantly higher in HIV(+) than in HIV(-)
       patients (17.4 vs 15.4, p = 0.01). Overall, cervical gonorrhea was more
       frequent than chlamydial infection (29% vs 9%), but among HIV infected
       women the prevalence of gonorrhea tended to increase with increasing
       immunosuppression (p = 0.07). Following oral antibiotic therapy with
       ciprofloxacin, doxycycline, and metronidazole, similar proportions of
       HIV(+) and HIV(-) patients (95% and 93%) reported symptomatic
       improvement within 4 days, and none had persistence of fever at day 4 or
       14 of follow-up. CONCLUSIONS: Based upon fever, clinical severity score,
       ultrasonographic diagnosis of TOM, requirement for surgery, and need of
       hospitalization, HIV infection was associated with more severe clinical
       manifestations of PID. Response to standardized oral antibiotic therapy
       was similar in HIV(+) and HIV(-) patients with PID.
 DE    Adnexitis/*COMPLICATIONS/PATHOLOGY  Case-Control Studies  Chlamydia
       Infections/COMPLICATIONS  Female  Gonorrhea/COMPLICATIONS  Human  HIV
       Infections/*COMPLICATIONS  HIV Seropositivity  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).