HIV-Positive Patients Can Do Well After Surgery

In a new study, researchers set out to observe surgical outcomes of HIV-patients compared with uninfected patients. Dr. Michael Horberg and colleagues reviewed the records for 332 HIV-positive patients who had had surgery between 1997 and 2002. During that time, antiretroviral drug cocktails were beginning to gain widespread use.

Horberg, who studies HIV patients for the Kaiser Permanente network of hospitals in California, wanted to see how HIV patients with access to ARVs fared after surgery. He compared them to uninfected patients of the same age and gender who had had the same operations. The study found that, overall, patients with HIV did fairly well. However, Horberg observed that among the sickest HIV patients, with high viral loads and weakened immunity, there were a few more pneumonias within one year post-op and a few more deaths.

The study concluded that doctors should not deny surgery to HIV patients for fear of doing harm. "If the surgery is urgent, go ahead and do the surgery," Horberg recommended, "but pay close attention to the issue of good pulmonary care around the time of surgery. If the surgery is elective, if you can hold off for a little while, put them on antiretroviral therapy; get their viral loads under control; and in most cases, that can be done in less than six months."

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