Prevalence and risk factors associated with perianal ulcer in advanced acquired immunodeficiency syndrome.

BACKGROUND

The aims of this study were to evaluate the prevalence of perianal ulcer in AIDS patients with advanced disease, and to investigate risk factors associated with these lesions.

METHODS

A cross-sectional study was conducted to determine the prevalence and risk factors associated with the presence of perianal ulcer in AIDS patients. A type-specific polymerase chain reaction (PCR) assay was carried out for detection of herpes simplex virus (HSV) DNA on swabs obtained from the ulcerative lesions.

RESULTS

In total, 272 hospitalized AIDS patients were included in the study, for evaluation of the risk factors associated with the lesion. Perianal ulceration was found in 25 of 272 patients (prevalence=9.2%). The presence of HSV DNA was shown by type-specific PCR in 22 of 23 (95.6%) patients. Multivariate analysis revealed that a history of esophageal candidiasis (odds ratio (OR)=15.1; 95% confidence interval (CI)=3.8-59.1) and a history of perianal ulcer (OR=19.2; 95% CI 6.4-58.1) were significant risk factors for the presence of perianal ulcer.

CONCLUSION

We conclude that a history of perianal ulcer and a history of esophageal candidiasis were risk factors independently associated with perianal ulcer in AIDS patients with advanced disease.