HIV infection and poor renal outcomes following noncardiac surgery

Abstract

Background/aim: The relevance of HIV infection in perioperative renal risk stratification remains unclear. This research sought to investigate the impact of HIV infection, as well as other established preoperative risk factors for poor perioperative renal outcome (PPRO), in a population of 565,225 adult noncardiac surgery patients whose data were obtained from the 2009-2011 California State Inpatient Database. Materials and methods: HIV status, established preoperative risk factors, and the study outcome (PPRO) were determined with the Clinical Classification Software codes recorded for each patient. Data were analyzed using univariate (Mann-Whitney U test, chi-square, and Fisher′s exact test) and multivariate (binary logistic regression) statistical methods. Results: The established preoperative risk factors were independently associated with PPRO. HIV infection was not an independent risk factor for PPRO in this study (odds ratio: 1.573, 95% confidence interval: 0.998-2.480; P = 0.051). Patients with HIV infection tended to have a higher burden of certain established preoperative risk factors for PPRO than patients without HIV infection. Conclusion: HIV-infected patients should be thoroughly screened for established preoperative risk factors and carefully managed during the perioperative period to reduce their risk of PPRO.

Outcomes following cholecystectomy in human immunodeficiency virus-positive patients treated with antiretroviral therapy: A retrospective cohort study

“…However, with advancements in ART, HIV infection is now becoming a controllable chronic disease (20,21). Some recent studies revealed that postoperative complication rates in patients with well-controlled HIV infections were comparable to those in HIV-negative patients (15,(22)(23)(24)(25)(26). CD4+ lymphocyte status is one of the indicators of HIV infection status (27,28), and various reports have revealed that a low CD4+ lymphocyte count (especially < 200 cells/μL) was associated with a significant increase in postoperative complications (12,29,30).…”