Clinical manifestations of infection with the human immunodeficiency virus in women in Louisiana

Abstract

To better understand the clinical manifestations of human immunodeficiency virus (HIV) infection in women in Louisiana, we conducted a retrospective review of the records of HIV-infected women who presented to the largest HIV outpatient clinic in Louisiana as well as to a tertiary care university hospital in New Orleans between January 1987 and December 1991. A total of 224 women were evaluated. Gynecologic examinations revealed that 17.5% had cervical intraepithelial neoplasia and that 35% had evidence of candidal vulvovaginitis or colonization. The following conditions were diagnosed among indicated percentages of patients: syphilis, 22.2%; Neisseria gonorrhoeae infection, 7.2%; Chlamydia trachomatis infection, 12.3%; pelvic inflammatory disease, 5.3%; trichomonal vulvovaginitis, 26.9%; genital ulcers due to herpes simplex virus, 16.5%; and clinically evident genital human papillomavirus infections, 16.5%. Both trichomonal vulvovaginitis and syphilis were more common among intravenous drug users. A total of 82 opportunistic processes were observed in 55 women. Pneumocystis carinii pneumonia was the most frequent complication of AIDS, followed by candidal esophagitis and wasting syndrome. Over 85% of women had received a diagnosis of AIDS before death. Gynecologic diseases occurred often in this population; the frequency of AIDS-defining events was similar to that reported previously in the literature.