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 stud y of acute PID was conducted in Nairobi, Kenya, Subjects underwent dia gnostic laparoscopy, HIV-I serology, and testing for sexually transmit ted diseases, Of the 133 women with laparoscopically verified salpingi tis, 52 (39%) were HIV-l-seropositive. Tube-ovarian abscesses (TOA) we re found in 33% of HIV-1-infected and 15% of HIV-1-uninfected women (o dds ratio [OR], 2.8; 95% confidence interval [CI], 1.2-6.5). Among ser opositive 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). Neis seria gonorrhoeae was detected in 37 women (28%) and Chlamydia trachom atis in 12 (9%); neither was significantly related to HIV-1 seropositi vity, Length of hospitalization was not affected by HIV-1 serostatus o verall but was prolonged among HIV-l-infected women with CD4 cell perc ent <14%, Among patients with acute salpingitis, likelihood of TOA was related to HIV-1 infection and advanced immunosuppression, In general , HIV-l-seropositive women with acute salpingitis responded well to tr eatment.