Nov 25, 2001
Maria is a 20 years old HIV infected. She is transfused for thalassemia major. At present she has CD4>200 with HAART therapy (Kaletra+Zerit+Videx). Recently we diagnosed a chronic active hepatitis, HCV related. Past month Maria has a laparoscopic cholecystectomy for cholecystitis. Surgery is followed by progressive hepatic failure and ascites. What can we do now?
Response from Dr. Rodriguez-Torres
It seems that Maria had much more liver disease than suspected before the surgery.It does not surprise me as many coinfected patients,have cirrhosis at baseline.This patients condition of Thalassemia,also can agravate the picture with hemolisys and thrombocytopenia.The only thing you can do know is to give support and manage the decompensation,and hope for slow recovery.Many cirrhotics can die from the hepatic complications of abdominal surgery.After and if the patient improves and recovers,management for the HCV can be considered.
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