ANTIBODIES TO THE CHLAMYDIAL 60 KD HEAT-SHOCK-PROTEIN ARE ASSOCIATED WITH LAPAROSCOPICALLY CONFIRMED PERIHEPATITIS

OBJECTIVE: Our purpose was to examine clinical, microbiologic, serolog ic, and laparoscopic findings associated with perihepatitis. STUDY DES IGN: In a prospective study of 157 women with a clinical diagnosis of pelvic inflammatory disease, 27 women with laparoscopically confirmed perihepatitis and salpingitis were compared with 46 patients with salp ingitis alone. RESULTS: Both current use or a history of ever using or al contraceptives was negatively associated with perihepatitis (p = 0. 05 and p = 0.008, respectively). Moderate-to-severe pelvic adhesions w ere present at laparoscopy significantly more often in the perihepatit is-salpingitis group (70%) than in the salpingitis alone group (35%, p = 0.003). Antibody to the chlamydial 60 kd heat-shock protein at grea ter than or equal to 0.5 optical density was detected in 67% of the pe rihepatitis-salpingitis group and in 28% of the salpingitis alone grou p (p = 0.005), and the median titer was significantly higher in the fo rmer group (p = 0.02). CONCLUSION: Compared with women with salpingiti s alone, patients with perihepatitis-salpingitis do not have distincti ve clinical or microbiologic findings but do manifest a higher prevale nce of moderate-to-severe pelvic adhesions and both a higher prevalenc e and higher titers of antibody to the chlamydial heat-shock protein-6 0.