High Prevalence of Gynecologic Disease Among Hospitalized Women with Human Immunodeficiency Virus Infection

We offered standardized gynecologic examinations to consecutive women admitted to an AIDSdesignated inpatient medical service; 65 (97%) of 67 women consented to the examination. The median CD4+ T lymphocyte count was 54/mm3. Only 9% of the women were admitted for primary gynecologic or genitourinary...

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Bibliographic Details
Published in:Clinical infectious diseases 1997-09, Vol.25 (3), p.706-712
Main Authors: Frankel, Renée E., Selwyn, Peter A., Mezger, JoAnne, Andrews, Susan
Format: Article
Language:English
Subjects:
Adult
AIDS
AIDS/HIV
Biological and medical sciences
Clinical Articles
Condylomata Acuminata - complications
Female
Female genital diseases
Genital Diseases, Female - complications
Genital Diseases, Female - diagnosis
Genitalia
Gynecological examination
Herpes Genitalis - complications
HIV
HIV infections
HIV Infections - complications
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infections
Medical sciences
Middle Aged
Pelvic inflammatory disease
Pelvic Inflammatory Disease - complications
Predictive Value of Tests
Symptoms
Uterine Cervical Dysplasia - complications
Vaginitis
Vaginitis - complications
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Summary:We offered standardized gynecologic examinations to consecutive women admitted to an AIDSdesignated inpatient medical service; 65 (97%) of 67 women consented to the examination. The median CD4+ T lymphocyte count was 54/mm3. Only 9% of the women were admitted for primary gynecologic or genitourinary diagnoses; however, on evaluation, 83% of these women had gynecologic disease. The overall prevalences of vaginitis, cervical dysplasia, genital condylomata, genital herpes, and pelvic inflammatory disease were 51%, 45%, 23%, 20%, and 5%, respectively. Unexpected findings included adenovirus infection and foscarnet-associated genital ulcerations (two cases each). For predicting disease, gynecologic symptoms had a sensitivity of 76% and a positive predictive value of 95% but a negative predictive value of only 41%. Our results document the high prevalence of comorbid gynecologic disease among women infected with human immunodeficiency virus (HIV). Because of the inability to fully predict disease by symptom history, it is imperative that comprehensive gynecologic evaluation be offered routinely to all HIV-infected women hospitalized for acute medical illnesses.
ISSN:1058-4838
1537-6591
DOI:10.1086/513775