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The association of puerperal sepsis with HIV infection at two tertiary hospitals in Zimbabwe
Author(s) -
Majangara Rumbidzai,
Chirenje Zvavahera M.,
Gidiri Muchabaiwa F.
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12695
Subject(s) - medicine , immunosuppression , sepsis , human immunodeficiency virus (hiv) , prospective cohort study , immunology , obstetrics
Abstract Objective To evaluate the association between HIV infection and puerperal sepsis among women in Zimbabwe. Methods A subanalysis was performed using data from a prospective cohort study conducted between September 2, 2014, and July 1, 2015, at two tertiary hospitals in Zimbabwe. Eligible participants were consecutive women who met the WHO criteria for puerperal sepsis. Variables assessed included HIV ‐infection status and the use of antiretroviral therapy. Severity of immunosuppression was defined by the number of T cells that expressed cluster of differentiation 4 ( CD 4). Endocervical swabs and blood samples were collected for microbial culture and susceptibility testing. Results In all, 33 (21.9%) of the 151 women included in the present analysis had HIV . Among women with HIV , severe immunosuppression ( CD 4‐positive T cell count <200/mm 3 ) was associated with a mean hospital stay of 19.0 days versus 10.2 days for mild‐advanced immunosuppression ( CD 4‐positive T cell count 200–500/mm 3 ) and insignificant immunosuppression ( CD 4‐positive T cell count >500/mm 3 ; P =0.030). Use of antiretroviral therapy did not independently influence clinical outcomes. Furthermore, infection with HIV did not influence the microorganisms isolated from blood or endocervical samples. Conclusion Severe immunosuppression was associated with increased length of hospitalization among women with HIV who had puerperal sepsis.