Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
PRNewswire - December 18, 2006
Researchers looked at the electronic and print medical records of HIV+ patients to determine how well they did compared with HIV-negative patients following both elective and urgent surgeries.
Researchers found few differences in the post-surgical outcomes between the two groups.
"The commonly held belief that HIV+ patients do worse is probably no longer valid," says lead researcher Michael A. Horberg, MD, MAS, Kaiser Permanente Director of HIV/AIDS Policy, Quality Improvement, and Research. "Our study confirms that surgery is safe for most healthier people who are HIV+." He explains that HIV+ patients are essentially healthier today due to the 1996 advent of Highly Active Anti-Retroviral Therapy (HAART), which combines at least three drugs to control the virus.
"What the results mean for patients who are HIV+ is if there is a need for elective or urgent surgery, in nearly all cases, HIV should not be a reason for holding off on having surgery," says Horberg. Furthermore, he adds, "Most of these patients will have no increased risk of surgical complications compared to their HIV-negative counterparts."
Horberg and the Kaiser Permanente research team analyzed 12-month post- surgical outcomes and mortality rates among 332 pairs of Kaiser Permanente HIV+ and HIV-negative patients. The patients had undergone everything from elective procedures such as hip/knee replacements to more urgent surgeries such as appendectomies from 1997 to 2002.
The HIV+ patients did nearly as well as their HIV-negative counterparts except when it came to pneumonia. The HIV+ patients came down with 12 cases vs. two in the HIV-negative group. Additionally, a small number of those infected with the HIV virus who carried higher viral loads (greater than 30,000 ml) and had a CD4 count under 50 suffered from increased complications compared to the rest of the HIV+ population studied. CD4 cells are a type of lymphocyte that helps fight viruses and other infections. Post-surgery complications can include such things as wound infections, longer lengths of stay in the hospital and bacterial infections.
In the current study, HIV+ patients were matched with HIV-negative patients by type of surgery, year the surgery took place, location of surgery, gender and age. The pairs had similar co-morbidities, lengths of stay in the hospital and number of surgical visits following their operations. More than two-thirds of the HIV+ patients had received HAART within 180 days prior to surgery and nearly 70 percent of the 332 had an AIDS diagnosis before undergoing a procedure.
"One of the things that prompted the current study was that previous research had conflicting results, showing both positive and negative outcomes," says Horberg. Also, he adds, "Pre-HAART-era research generally posited that surgical outcomes were worse, but these studies were often inconsistent, with small sample sizes."
The study was funded through the Kaiser Permanente Northern California Community Benefit Program. Additional Kaiser Permanente researchers on the study include Leo Hurley, MPH; Daniel B. Klein, MD; Stephen E. Follansbee, MD; Charles Quesenberry, PhD; Jason Flamm, MD; Gary Green, MD; and Tye Luu, RN.
The Kaiser Permanente Division of Research conducts, publishes, and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Currently, DOR's 400-plus staff is working on more than 250 epidemiological and health services research projects.
For more information about Kaiser Permanente research, go to: http://blog.kaiser-permanente.org/research/ .
SOURCE Kaiser Permanente
http://www.kaiserpermanente.org
061218
PR061240
Copyright © 2006 - PRNewswire. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through PRNewswire, Permissions, 810 Seventh Ave., 32nd Floor, New York, NY 10019 http://www.prnewswire.com.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, the National Library of Medicine, Pacific Life Foundation and donations from users like you.
Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .