HIV-associated rectovaginal fistulae in children: a single-centre retrospective study in the antiretroviral era

Topic overview

Key takeaways

• HIV-associated rectovaginal fistulae in children typically present around age 2 years and require staged surgical repair with diverting colostomy.
• Fistula recurrence occurred in 44% of cases, with complications including anal stenosis and perineal sepsis being common postoperatively.
• Viral suppression is critical for successful outcomes—failure to maintain suppression was significantly associated with fistula recurrence.
• Ischiorectal fat pad interposition was used in over half of repairs as part of the reconstructive approach.
• Despite challenges, 78% of patients achieved good functional outcomes without soiling after staged repair and stoma reversal.

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