Human Immunodeficiency Disease: How Should It Affect Surgical Decision Making?

Abstract

HIV infection should not be considered a significant independent factor for major surgical procedures. Appropriate surgery should be offered as in normal surgical patients without fear of an unfavorable outcome.

Effect of CD4+ T-lymphocyte count on hospital outcome of elective general thoracic surgery patients with human immunodeficiency virus

“…The appropriate surgery should be offered as it would be for HIV-negative surgical patients, without fear of an unfavorable outcome. 12 Our results were similar to those reported after 2006; especially, CD4 cell counts had no relation to the surgical outcome, and inadequate control of the HIV-RNA viral load may be associated with a poor prognosis. We observed that the HIV-RNA viral load was high in our patients who did not receive HAART.…”

Critical care admission of South African (SA) surgical patients: Results of the SA Surgical Outcomes Study

“…The HIV infection rate may not be accurate, as the status was not determined for all patients and unconsented testing is still controversial. The prognostic implications of HIV in surgical patient outcomes have already been explored by some authors, [12][13][14][15] with conflicting results, but were not found to be associated with surgical mortality in SASOS [3] or in patients admitted to critical care units. The sepsis rate in critical care admissions in SA is of concern, with 35.4% of patients having suspected or confirmed infection on ICU admission.…”

A 10 years audit of cardiothoracic referrals from a pulmonology service in a developing country: impact of patient human immunodeficiency virus status

“…This is particularly so in sub-Saharan Africa/South Africa given the significant ongoing impact of HIV infection in the population (13). A question that has often been asked is what impact HIV infection has on the complication rate and mortality in association with surgical procedures and should it affect surgical decision making (14). One study undertaken earlier on in the HIV epidemic among patients having surgical management for thoracic manifestations of HIV infection, documented that the mortality rate appeared to be linked to the stage of HIV infection at the time of therapy, rather than the type of surgery undertaken (15).…”

“…Other investigators undertaking a literature review of the topic came to the conclusion, as we would, that in otherwise asymptomatic HIV-infected patients, appropriate surgery for the circumstances should be undertaken without much concern about the likelihood of an unfavourable outcome (14). However, cases do need to be evaluated for their state of immunosuppression and in patients with advanced disease, palliative surgery could still be used for relief of acute problems (14).…”

“…However, cases do need to be evaluated for their state of immunosuppression and in patients with advanced disease, palliative surgery could still be used for relief of acute problems (14).…”