The association of puerperal sepsis with HIV infection at two tertiary hospitals in Zimbabwe

Objective To evaluate the association between HIV infection and puerperal sepsis among women in Zimbabwe. Methods A subanalysis was performed using data from a prospective cohort study conducted between September 2, 2014, and July 1, 2015, at two tertiary hospitals in Zimbabwe. Eligible participants were consecutive women who met the WHO criteria for puerperal sepsis. Variables assessed included HIV‐infection status and the use of antiretroviral therapy. Severity of immunosuppression was defined by the number of T cells that expressed cluster of differentiation 4 (CD4). Endocervical swabs and blood samples were collected for microbial culture and susceptibility testing. Results In all, 33 (21.9%) of the 151 women included in the present analysis had HIV. Among women with HIV, severe immunosuppression (CD4‐positive T cell count 500/mm3; P=0.030). Use of antiretroviral therapy did not independently influence clinical outcomes. Furthermore, infection with HIV did not influence the microorganisms isolated from blood or endocervical samples. Conclusion Severe immunosuppression was associated with increased length of hospitalization among women with HIV who had puerperal sepsis. Severe immunosuppression in response to HIV infection was associated with prolonged duration of hospitalization for puerperal sepsis among women in Zimbabwe.