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Aug 24, 2003

I am newly diagnosed-not onn meds. ok tcells and high vl. Is it ok for me to have plastic surgery, like a nose job and chin implant, or should I wait until I am on meds. Also, do i have to tell the dr my status--i dont want to as it is embarrasing and private. I hate to have the nurses and assistants know.

Response from Dr. Pierone

It may be all right for you to have plastic surgery with ok T cells (how ok?) despite the high viral load (how high?) but likely to be safer to be on meds. You should tell the surgeon about your HIV status because there are practical implications. Needle-stick injuries with HIV exposure to operating room staff may occur at the time of surgery. There is often a delay in providing post-exposure prophylaxis to health care workers when the HIV status of the patient is unknown. If they are aware of HIV status before surgery, post-exposure prophylaxis can be started right away in the case of an accidental exposure. If you deferred surgery until after HIV treatment and had an undetectable viral load this would also lessen the risk of transmission in case of needle-stick exposure.

HIV status is private information, but in the case of elective surgery, this information should be shared with the other stakeholders in the process. I fully realize that there is still stigma associated with HIV in our society, but don't be embarrassed and give power to anyone so ignorant that they don't realize that persons with HIV are no different from anyone else.

stats are confusing
facial wasting

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