Human Immunodeficiency Virus-Related Abdominal Pain in South Africa: Aetiology, Diagnosis, and Survival

Background: Abdominal pain in acquired immunodeficiency syndrome (AIDS) patients is often a marker of an underlying opportunistic pathologic condition. There are no data on HIV-related abdominal pain in Africa. Methods: Forty-four consecutive Cape Town patients with advanced human immunodeficiency v...

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Bibliographic Details
Published in:Scandinavian journal of gastroenterology 1998, Vol.33 (2), p.212-217
Main Authors: O'KEEFE, E. A, WOOD, R, VAN ZYL, A, CARIEM, A. K
Format: Article
Language:English
Subjects:
Abdominal Pain - complications
Abdominal Pain - diagnosis
Abdominal Pain - microbiology
Adolescent
Adult
AIDS-Related Opportunistic Infections - complications
AIDS-Related Opportunistic Infections - diagnosis
AIDS-Related Opportunistic Infections - mortality
AIDS/HIV
Biological and medical sciences
Female
Gastrointestinal Diseases - complications
Gastrointestinal Diseases - diagnosis
Gastrointestinal Diseases - microbiology
HIV Infections - complications
HIV Infections - mortality
Human viral diseases
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
Prognosis
Prospective Studies
South Africa
Survival Rate
Tuberculosis - complications
Tuberculosis - diagnosis
Tuberculosis - mortality
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:Background: Abdominal pain in acquired immunodeficiency syndrome (AIDS) patients is often a marker of an underlying opportunistic pathologic condition. There are no data on HIV-related abdominal pain in Africa. Methods: Forty-four consecutive Cape Town patients with advanced human immunodeficiency virus (HIV) infection (CD4 < 200) and abdominal pain were studied prospectively to determine aetiology and survival. Results: A probable cause of pain was identified in 37 (84%): disseminated Mycobacterium tuberculosis infection in 11, cryptosporidiosis in 6, cytomegalovirus infection in 6, and atypical mycobacterial infection in 2. Gastrointestinal lymphoma and pancreatitis were not seen. Fever, hepatomegaly, respiratory symptoms, abnormal chest radiograph, and adenopathy, ascites, or abscesses on ultrasound had predictive diagnostic value for disseminated M. tuberculosis. Fifty-one per cent of abdominal pain patients survived 6 months, compared with 73% of all AIDS patients (P < 0.001). Conclusions: The aetiology of HIV-related abdominal pain in Cape Town reflects the high local prevalence of tuberculosis. Clinical and ultrasound features facilitate diagnosis. Abdominal pain is associated with poor survival.
ISSN:0036-5521
1502-7708
DOI:10.1080/00365529850166978