{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T05:28:16Z","timestamp":1734067696954,"version":"3.30.2"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of the Witwatersrand"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Acquired rectovaginal fistulae (RVF) are a complication of paediatric HIV infection. We report our experience with the surgical management of this condition.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrospectively reviewed the records of paediatric patients with HIV-associated RVF managed at Chris Hani Baragwanath Academic Hospital (2011\u20132023). Information about HIV management, surgical history, and long-term outcomes was collected.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Ten patients with HIV-associated RVF were identified. Median age of presentation was 2\u00a0years (IQR: 1\u20133\u00a0years). Nine patients (9\/10) underwent diverting colostomy, while one demised before the stoma was fashioned. Fistula repair was performed a median of 17\u00a0months (IQR: 7.5\u201355\u00a0months) after colostomy. An ischiorectal fat pad was interposed in 5\/9 patients. Four (4\/9) patients had fistula recurrence, 2\/9 patients developed anal stenosis, and 3\/9 perineal sepsis. Stoma reversal was performed a median of 16\u00a0months (IQR: 3\u201325\u00a0months) after repair. Seven patients (7\/9) have good outcomes without soiling, while 2\/9 have long-term stomas. Failure to maintain viral suppression after repair was significantly associated with fistula recurrence and complications (\u03c6\u2009=\u20090.8, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>While HIV-associated RVFs remain a challenging condition, successful surgical treatment is possible. Viral suppression is a necessary condition for good outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00383-024-05762-5","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T05:01:50Z","timestamp":1720414910000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["HIV-associated rectovaginal fistulae in children: a single-centre retrospective study in the antiretroviral era"],"prefix":"10.1007","volume":"40","author":[{"given":"Piero","family":"Alberti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Westgarth-Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Trovalusci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Charlton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Brisighelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,8]]},"reference":[{"issue":"2","key":"5762_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1002\/path.4449","volume":"235","author":"S Lucas","year":"2015","unstructured":"Lucas S, Nelson AM (2015) HIV and the spectrum of human disease. 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