Tag Archives: HIV

Kaposi Sarcoma in HIV Infected Patients

DOI: 10.1515/amma-2016-0019

Objective: The aim of the study was to describe clinical and laboratory characteristics in HIV-infected patients with Kaposi sarcoma (KS).
Methods: We retrospectively studied data on HIV-infected patients hospitalized in one tertiary care hospital in Bucharest, Romania, in whom Kaposi Sarcoma was diagnosed, between January 2008 and November 2013.
Results: We identified 27 HIV-infected patients diagnosed with KS within 6 years. They had a median age of 42 years old and a median CD4 cell count of 101 cells per mm3 at the time of KS diagnosis. All patients received antiretroviral therapy (ART), with 18 patients (66%) already on ART at the time of KS diagnosis. Most patients (59%) were classified as ACTG poor-risk and 56% as Mitsuyasu stage I. The overall prognosis was poor, with 41% mortality, in a median time span of 6 months, significantly correlated with gastrointestinal involvement (p=0.019), poor-risk KS in ACTG classification (p<0.001) and stage IV Mitsuyasu (p=0.006).
Conclusion: KS remains an important cause of morbidity and mortality in patients with HIV infection, especially in late presenters.

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Management Algorithm for Surgical Patients Infected with Human Immunodeficiency Virus

Objective: The purpose of this study was to establish the risk factors which influence the postoperative evolution of surgical patients infected with human immunodeficiency virus (HIV), and to conceive a management algorithm based upon these factors.
Methods: We have performed a bidirectional transversal study on a group of 73 HIV-positive patients who had undergone 104 surgical procedures during 2006–2010 in the university medical center of Tîrgu Mureş. We studied risk factors such as the number of CD4 T-cells (LTCD4) < 100/µl, anemia, thrombocytopenia, hypoproteinemia, leukopenia, wasting syndrome, ASA (American Society of Anesthesiologists) score, Altemeier class and NNISS (National Nosocomial Infections Survey Systems) score. We defined any registered postoperative complication, as well as all deaths within the first 30 days from surgery as poor outcome. We used GraphPad statistical program, Fisher test for the statistical analysis of data, we interpreted p <0.05 as statistically significant, for a CI of 95%.
Results: We have registered a total of 15 complications, 5 deaths. Risk factors associated with poor postoperative outcome were LTCD4 <100/µl (p=0.03) wasting syndrome (p=0.0001), ASA score > 1 (p=0.01), Altemeier class > II (p=0.0001), NNISS score 1 (p=0.0001).
Conclusions: HIV-infected patients with emergency surgical pathology will benefit of surgical treatment when the anesthetic risk does not overpass the surgical risk, while patients who require elective interventions will be operated after the correction of risk factors.

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