1. Effects of human immunodeficiency virus 1 infection on microbial origins of pelvic inflammatory disease and on efficacy of ambulatory oral therapy.
- Author
-
Bukusi EA, Cohen CR, Stevens CE, Sinei S, Reilly M, Grieco V, Eschenbach DA, Holmes KK, Bwayo J, Ndinya-Achola JO, and Kreiss J
- Subjects
- Administration, Oral, Adolescent, Adult, Ambulatory Care, Anti-Bacterial Agents administration & dosage, Chlamydia Infections microbiology, Chlamydia trachomatis isolation & purification, Endometritis complications, Endometritis epidemiology, Female, Gonorrhea microbiology, HIV Antibodies blood, HIV Seropositivity epidemiology, Humans, Kenya epidemiology, Multivariate Analysis, Neisseria gonorrhoeae isolation & purification, Severity of Illness Index, Surveys and Questionnaires, Treatment Outcome, Vaginosis, Bacterial epidemiology, Anti-Bacterial Agents therapeutic use, Endometritis drug therapy, Endometritis microbiology, HIV Seropositivity complications, HIV-1 immunology, Vaginosis, Bacterial microbiology
- Abstract
Objective: This study was undertaken to determine the effects of human immunodeficiency virus 1 infection on the clinical presentation, severity, causal organisms, and response to ambulatory therapy of pelvic inflammatory disease., Study Design: Women 18 to 40 years old with lower abdominal pain for <1 month were recruited. Participants underwent a standardized questionnaire, physical examination, screening for human immunodeficiency virus 1 and other sexually transmitted infections, and endometrial biopsy to detect plasma cell endometritis. Reevaluations were performed at 1 and 4 weeks to assess response to therapy., Results: Among 162 women with adequate endometrial biopsy specimens 63 (39%) had histologically confirmed endometritis. Endometritis was more frequent among women who were seropositive for human immunodeficiency virus 1 than among women who were seronegative (odds ratio, 3.0; 95% confidence interval, 1.5-5.9). Infections with either Neisseria gonorrhoeae or Chlamydia trachomatis, or both, were least common and bacterial vaginosis was most common among human immunodeficiency virus 1-infected women with CD4 T-lymphocyte counts <400 cells/microL (P <. 04, P <.03, respectively). After oral antibiotic therapy, similar proportions of both women who were seropositive and women who were seronegative for human immuno-deficiency virus 1 had a >/=75% reduction in clinical severity score (81% vs 86%)., Conclusion: Outpatient treatment of pelvic inflammatory disease was successful regardless of human immunodeficiency virus 1 serostatus.
- Published
- 1999
- Full Text
- View/download PDF