Radical prostatectomy in patients infected with human immunodeficiency virus Journal Article
| Authors: | Huang, W. C.; Kwon, E. O.; Scardino, P. T.; Eastham, J. A. |
| Article Title: | Radical prostatectomy in patients infected with human immunodeficiency virus |
| Abstract: | OBJECTIVE: To present the complications and early outcomes in a small series of men infected with human immunodeficiency virus (HIV) and treated with radical prostatectomy (RP) for prostate cancer, and to review reports on surgery in HIV-positive patients. PATIENTS AND METHODS: During 2002-2005, seven men infected with HIV underwent RP at our institution. For the five patients whose HIV status was known before surgery, we retrospectively examined preoperative variables, including HIV-specific data (clinical category, CD4+ lymphocyte count, viral load, duration of HIV diagnosis, and opportunistic infections), and the complications and early outcomes after RP. RESULTS: Before RP all the patients were in the Center for Disease Control clinical category A (asymptomatic HIV infection). The CD4+ counts before RP ranged from 269-870 cells/μL and viral loads ranged from <50-18 700 copies/mL. Three patients were on highly active anti-retroviral therapy (HAART) at the time of surgery. After RP, two patients had incisional wound infections, including one requiring re-hospitalization for intravenous antibiotics. During the follow-up (median 26 months) none of the patients progressed to acquired immunodeficiency syndrome or developed biochemical recurrence of prostate cancer. One healthcare worker was exposed to contaminated urine and placed on prophylactic therapy, but has not sero-converted. CONCLUSION: The risk of peri-operative complications in HIV-positive patients can be minimized by carefully selecting the patient and procedure, and by measuring routine and HIV-specific preoperative variables. The two infectious complications in this series were in patients with less favourable preoperative factors, i.e. the lowest CD4+ count and the highest viral load. Further experience is needed to determine whether the risk of surgical infections is higher in this cohort. However, our results are consistent with reports from other surgical specialities that surgery in asymptomatic HIV-positive patients is safe and effective. © 2006 The Authors. |
| Keywords: | adult; clinical article; human tissue; middle aged; antibiotic agent; antibiotic therapy; retrospective studies; human cell; disease course; cancer recurrence; nonhuman; patient selection; human immunodeficiency virus infection; outcome assessment; follow up; preoperative evaluation; risk assessment; prostate cancer; postoperative complication; prostatic neoplasms; prostatectomy; patient safety; surgical infection; health care personnel; radical prostatectomy; disease duration; human immunodeficiency virus; acquired immune deficiency syndrome; antiretrovirus agent; cd4 lymphocyte count; highly active antiretroviral therapy; virus load; hospital readmission; cd4 antigen; hiv infections; hiv; opportunistic infection; occupational exposure; intraoperative complications; peroperative complication; seroconversion |
| Journal Title: | BJU International |
| Volume: | 98 |
| Issue: | 2 |
| ISSN: | 1464-4096 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2006-08-01 |
| Start Page: | 303 |
| End Page: | 307 |
| Language: | English |
| DOI: | 10.1111/j.1464-410X.2006.06271.x |
| PUBMED: | 16879669 |
| PROVIDER: | scopus |
| PMCID: | PMC2239296 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 11" - "Export Date: 4 June 2012" - "CODEN: BJINF" - "Source: Scopus" |
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