This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (4)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in this journal  Topic Collections  • Surgical Interventions, Other  • Review  • Prognosis/ Outcomes  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Twenty Years Later

Darin J. Saltzman, PhD, MD; Russell A. Williams, MD; Dmitri V. Gelfand, MD; Samuel E. Wilson, MD

Arch Surg. 2005;140:961-967.

Background  Since the first reports on indications and outcome for abdominal procedures in the HIV/AIDS patient were published 20 years ago, the epidemiology and presentation of surgical illness have changed remarkably with the advent of new antiviral regimens. A review of the now occasional, but still important, role of the surgeon in contemporary treatment of HIV/AIDS is presented.

Data Sources  Information was obtained by PubMed searches of medical journals, examination of reference lists, and Web resources.

Study Selection  Articles on operative indications, outcomes, precautions, source of transmission, and pathophysiology of HIV/AIDS were selected.

Data Extraction  Data was obtained from peer-reviewed articles and references.

Data Synthesis  The last 2 decades have seen a decrease in operative mortality from as high as 85% to approximately 15% with a corresponding improvement in morbidity. Surgical emergencies such as appendicitis occur in HIV patients with the same frequency as non-HIV patients and are treated with equivalent results. Concern about transmission of HIV in the operating room has lessened somewhat. Although still a hazard, the probability of HIV transmission with accidental exposure is low, with risks below 0.5% for percutaneous hollow-bore needles and less than 0.1% risk for mucus membrane exposure.

Conclusions  Improved surgical outcomes together with of accurate data on the modes and likelihood of accidental transmission of HIV to members of the surgery team have resulted in the treatment of HIV/AIDS patients becoming an accepted part of routine surgical practice.

Author Affiliations: Department of Surgery, University of California, Irvine Medical Center, Orange.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Prevention of Occupational Human Immunodeficiency Virus Transmission in Surgeons in the Era of Highly Active Antiretroviral Therapy
Vincenzo Puro, Gabriella De Carli, and for the Italian Registry of Antiretroviral Post-Exposure Prophylaxis and the Studio Italiano Rischio Occupazionale da HIV
Arch Surg. 2006;141(6):611.
EXTRACT | FULL TEXT  

Surgical Site Infections in Patients With Human Immunodeficiency Virus
Nicola Petrosillo, Angelo Pan, Vincenzo Puro, and for the Gruppo HIV e Infezioni Ospedaliere
Arch Surg. 2006;141(6):611-612.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Prevention of occupational human immunodeficiency virus transmission in surgeons in the era of highly active antiretroviral therapy.
Puro et al.
Arch Surg 2006;141:611-611.
FULL TEXT  

Surgical Site Infections in Patients With Human Immunodeficiency Virus
Petrosillo et al.
Arch Surg 2006;141:611-612.
FULL TEXT