Effect of HIV infection on outcomes after surgical repair of genital fistula

Abstract

Objective: To compare outcomes following surgical repair of genital fistula among Nigerian women with or without HIV. Methods: A retrospective review was conducted of all genital fistula repair surgeries performed at Evangel Vesicovaginal Fistula Center in Jos, Nigeria, between January 1, 2004, and April 30, 2014. Patient characteristics, HIV status, genital fistula characteristics, and postoperative outcomes were assessed for between-group variance. The odds ratio (OR) and 95% confidence intervals (CIs) were the primary measures used for determining the association between HIV status and surgical outcomes. Results: Of the 3313 surgeries recorded, 201 (6.1%) were performed among patients with HIV infection. No statistically significant between-group differences were found for patient or fistula characteristics. By contrast, failed vesicovaginal failure (VVF) closure was significantly more common among women infected with HIV than among their HIV-negative counterparts (OR 0.629, 95% CI 0.443–0.894). No between-group differences in failure rates were found for ureterovaginal or rectovaginal fistulas. Conclusion: Determining HIV status before surgery could aid prediction of outcomes among Nigerian women undergoing repair of VVF. Further studies are required to examine factors that might improve outcomes for women with HIV infection.