Major surgery seems not to influence HIV disease progression in haemophilia patients.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Major surgery seems not to influence HIV disease progression in haemophilia patients.

Br J Haematol. 1998 Oct;103(1):10-4. Unique Identifier : AIDSLINE MED/99006768
Astermark J; Lofqvist T; Schulman S; Stigendal L; Lethagen S; Nilsson IM; Berntorp E; Department of Coagulation Disorders, University of Lund,; University Hospital, Malmo, Sweden.

Abstract: The influence of major surgery on HIV disease progression and decline in CD4+ cell count was evaluated in 23 seropositive haemophilia patients. 24 HIV-infected patients served as non-operated controls. In addition, 32 age-matched seronegative subjects were included. The follow-up time was up to 5 years. During the course of the study, eight of the operated (35%) and 11 of the non-operated (48%) subjects developed HIV-related symptoms (P=0.267). The relative risk for developing HIV-related symptoms after surgery was 0.60 (95% CI 0.25; 1.48). A significant decline in CD4+ cell counts was observed in both the surgery (4.0 x 10(6)/l/month, 95% CI 2.0; 6.0 x 10(6), P=0.001) and the non-surgery (4.0 x 10(6)/l/month, 95% CI 2.0; 6.0 x 10(6), P=0.004) seropositive subgroup, but no difference between the two subgroups was seen (P=0.793). HIV (6.0 x 10(6)/l/month, 95% CI 2.1; 9.9 x 10(6), P=0.0005) but not surgery (-1.0 x 10(6)/l/ month, 95% CI -3.0; 0.96 x 10(6), P=0.647) was an independent predictor for the decline in CD34+ cell count. No interaction effect was observed between HIV infection and surgery (P=0.361). The annual amount of factor concentrate used for regular replacement therapy did not influence the decline in CD4+ cell count (P=0.492). We conclude that major surgery may be considered in symptom-free HIV-seropositive haemophilia patients, with CD4+ cell counts > or = 0.20 x 10(9)/l under similar premises as for seronegative subjects.

Keywords: CLINICAL TRIAL CONTROLLED CLINICAL TRIAL JOURNAL ARTICLE MULTICENTER STUDY Adolescence Adult Aged Aged, 80 and over Child Comparative Study CD4 Lymphocyte Count Disease Progression Follow-Up Studies Hemophilia A/*COMPLICATIONS/IMMUNOLOGY Human HIV Infections/*COMPLICATIONS/IMMUNOLOGY HIV Seropositivity Middle Age Support, Non-U.S. Gov't Surgical Procedures, Operative/*ADVERSE EFFECTS
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A9931121

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