Perineal Disintegration Syndrome (PDS) in Children With Human Immunodeficiency Virus (HIV) Infection: A Scoping Review

Abstract

Background: Paediatric healthcare for children with HIV involves managing complex challenges, including severe perineal issues that significantly affect their quality of life. We introduce the term "perineal disintegration syndrome" (PDS) to describe conditions characterised by abscesses and various fistulae involving the anus, rectum, urethra, or reproductive tracts. The literature on PDS is limited and lacks a standardised treatment approach and universally accepted terminology. Our proposal for a new term aims to standardise nomenclature and stimulate targeted research to improve management and outcomes for this vulnerable group.

Objectives: The aim of the study was to conduct a comprehensive analysis of the existing literature on PDS in paediatric HIV patients to uncover key findings, identify knowledge gaps, and outline practical implications and recommendations for clinical care and future research.

Methods: A systematic search across databases with comprehensive keywords identified relevant articles on PDS in paediatric HIV patients was conducted.

Results: The review emphasises the focus of PDS literature in African nations, highlighting the urgent need for research and clinical attention in HIV/AIDS-burdened regions. Challenges in diagnosing and managing PDS, uncertainties in its causes, and the lack of standardised management approaches in resource-constrained settings were revealed.

Conclusion: This review emphasises the importance of prospective research, standardised protocols and patient-centred multidisciplinary care in managing PDS in paediatric HIV patients to improve care and outcomes of this population.

Level of evidence: I.

Keywords: Human immunodeficiency virus; Paediatric; Perianal abscess; Perianal fistula; Perineal disintegration; Rectourethral fistula; Rectovaginal fistula.