HIV Postoperative Mortality Reduced by ART

Patients with HIV who receive antiretroviral therapy (ART) were found to have lower postoperative mortality rates in a study published online recently in JAMA Surgery.

The study also found mortality rates to be equally as influenced by age and hypoalbuminemia as they were by CD4 cell counts.

The researchers examined medical data from the US Veterans Health Administration Healthcare System from 1996 to 2010 in order to compare 30-day postoperative mortality in patients with HIV who received ART with mortality rates for uninfected patients. The data included 1641 patients with HIV who were receiving ART and undergoing inpatient surgery compared with 3282 uninfected patients who were matched by surgical procedure. The most common procedures in both groups were cholecystectomy (10.5%), hip arthroplasty (10.5%), spine surgery (9.8%), herniorrhaphy (7.4%), and coronary artery bypass grafting (7%).

The HIV-infected patients had a 30-day postoperative mortality rate of 3.4%, while uninfected patients had a mortality rate of 1.6%. Patients with HIV also had increased mortality across all CD4 cell count levels compared with patients who are uninfected.

“HIV-infected individuals with a CD4 cell count higher than 200/μL can be expected to have a postoperative mortality rate similar to that in an uninfected individual 16 years older: surgery on a 50-year-old patient with HIV infection who is receiving ART has a 30-day mortality risk similar to that of a 66-year-old individual without the infection,” the study authors wrote.