Anorectal Diseases in HIV Positive Patients: Experience with 112 Patients
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 1
Abstract
Anorectal disease is the most common reason for surgical referral in patients HIV-positive patients. Anorectal pathology is seen in approximately one-third of these patients. It is estimated that more than one- half of these patients will require surgery. The objectives were to study the manifestations and modality of anorectal diseases in HIV positive patients, the impact of homosexuality and to estimate the overall outcome of surgical management. This is a cross sectional hospital based study done on patients infected with HIV who had anorectal symptoms in Gadarif Teaching Hospital from Mar. 2012- Mar. 2014. Seventy eight percent of the 112 patients in this study were males (range, 19-61) years with M: F ratio of 2:1. Their mean age was 34.3. Homosexuality was the most common in term of risk factors, present in 32 (28.6%) patients. The most common symptoms were anorectal swelling 47 (42%) patients, ulcer was in 43(38.4%) patients, pain present in 18 (16.1%) patients, and anal bleeding seen in 4 (3.6%) patients. The most common disorders was anorectal ulcer in 43 (38.4%) patients, Fistulas in 30 (26.8%) patients, abscess in 14 (12.5%) patients, haemorrhoidal diseases in 11(9.8%) patients, Condyloma present in seven (6.2%) and fissure in five (4.5%) patients. Anal neoplasms were identified in two (1.8%) patients. A total of 68 procedures were performed on 68 patients. Seven different types of procedures were performed on 60.7 % of our patients. Majority of the cases were clinically stage IV 82 (73.2%) patients. Ninety-three (83.0%) patients were already using ARTs. Fifty seven (83.8%) patients out of those who underwent procedures were completely resolved during follow-up, at an average time of 12 weeks. HIV positive patients showed variable and multiple perianal manifestations. They require treatment throughout the course of HIV infection. Despite challenged immunity of HIV-positive patients, patients receiving appropriate care at a proper time should expect low complications after any surgical procedure.
Authors and Affiliations
Majdi AO Bakhiet, Sami E Salah, Aamir A Hamza
Keywords
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