[Upper genital tract infections in women infected with HIV: epidemiologic, diagnostic and therapeutic aspects].

Fifty seven women hospitalized in the gynecological department of Bichat-Claude Bernard hospital in Paris for pelvic inflammatory disease (PID) proven by laparoscopy from sept. 1992 to nov. 1994 had a serological diagnosis of HIV infection. Three of them (5,2%) were positive (HIV+). Previous publications have shown from 4% to 17% in the USA and as much as 32% in Abidjan. However this prevalence is arising each year. PID in HIV+ seems to have more often a poor symptomatology but require more surgical treatments. Postpartum endometritis in HIV+ were also studied. From 1989 to 1994, we observed 109 delivery in HIV+ patients. Numerous infectious diseases occurred but endometritis were not significantly elevated. Three american studies in HIV+ failed to show an increased risk of postpartum endometritis but a fourth larger study achieved in Abidjan, showed a significantly higher risk of endometritis, associated with decreasing levels of CD4. HIV+ women are at increased risk of upper genital tract infection and could profit from obstetrical antibioprophylaxis.