Male circumcision wound healing in human immunodeficiency virus (HIV)‐negative and HIV‐positive men in Rakai, Uganda. (27th November 2013)

• Record Type: Journal Article
• Authors: Kigozi, Godfrey; Musoke, Richard; Kighoma, Nehemiah; Watya, Stephen; Serwadda, David; Nalugoda, Fred; Kiwanuka, Noah; Nkale, James; Wabwire‐Mangen, Fred; Makumbi, Frederick; Sewankambo, Nelson K.; Gray, Ronald H.; Wawer, Maria J.
• Is Part Of: BJU international. Volume 113:Number 1(2014:Jan.)
• Page Start: 127
• Page End: 132
• Publication Date: 2013-11-27
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12406
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12406-sec-0001" sec-type="section"> <title>Objective</title> <p> <list id="bju12406-list-0001" list-type="bullet"> <list-item> <p>To assess completed wound healing after medical male circumcision (MMC) among human immunodeficiency virus (HIV)‐negative and HIV‐positive men with cluster of differentiation 4 (CD4) counts of <350 and ≥350 cells/mm<sup>3</sup>, as minimal data are available on the safety of MMC among HIV‐positive men with low CD4 counts.</p> </list-item> </list> </p> </sec> <sec id="bju12406-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p> <list id="bju12406-list-0002" list-type="bullet"> <list-item> <p>In all, 262 HIV‐negative and 177 HIV‐positive consenting males aged ≥12 years accepted MMC using the dorsal slit procedure and were enrolled in the study.</p> </list-item> <list-item> <p>Socio‐demographic and behavioural data and blood for HIV testing and CD4 counts were collected at baseline.</p> </list-item> <list-item> <p>Participants were followed weekly to collect information on resumption of sex, condom use and both self‐reported and clinically assessed wound healing.</p> </list-item> <list-item> <p>The proportions healed among HIV‐positive men were compared with HIV‐negative men. Time to complete wound healing was assessed by Kaplan–Meier survival analysis.</p> </list-item> </list> </p> </sec> <sec id="bju12406-sec-0003" sec-type="section"> <title>Results</title> <p> <list id="bju12406-list-0003" list-type="bullet"> <list-item> <p>There were no statistically significant differences in the proportion of men healed by HIV status.</p> </list-item> <list-item> <p>At 4 weeks, the proportions healed were 85.9% in HIV‐negative men, 77.4% in HIV‐positive men with a CD4 count of ≥350 cells/mm<sup>3</sup> and 87.1% in HIV‐positive men with a CD4 count of <350 cells/mm<sup>3</sup>.</p> </list-item> <list-item> <p>The median time to healing was 4 weeks and did not vary by HIV or CD4 status.</p> </list-item> <list-item> <p>All men had certified complete wound healing at 6 weeks after MMC. In all, 1.4% of HIV‐positive men with a CD4 count of <350 cells/mm<sup>3</sup> resumed sex before healing, compared with 8.5% among HIV‐positive men with a CD4 count of ≥350 cells/mm<sup>3</sup> (<italic>P</italic> = 0.052) and 7.8% (<italic>P</italic> = 0.081) among HIV‐negative men.</p> </list-item> </list> </p> </sec> <sec id="bju12406-sec-0004" sec-type="section"> <title>Conclusion</title> <p> <list id="bju12406-list-0004" list-type="bullet"> <list-item> <p>Inclusion of HIV‐positive men with low CD4 counts in MMC services is not deleterious to postoperative wound healing.</p> </list-item> </list> </p> </sec> </abstract>