Journal Article

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

Renée E. Frankel, Peter A. Selwyn, JoAnne Mezger and Susan Andrews

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 3, pages 706-712
Published in print September 1997 | ISSN: 1058-4838
Published online September 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/513775
High Prevalence of Gynecologic Disease Among Hospitalized Women with Human Immunodeficiency Virus Infection

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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.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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