Improved outcomes following gastrointestinal surgery among people living with HIV in the HAART-era: A scoping review

Victoria H Chen; Keiko M Patterson; Julio Montaner; Sam M Wiseman

doi:10.1016/j.amjsurg.2024.03.006

Improved outcomes following gastrointestinal surgery among people living with HIV in the HAART-era: A scoping review

Am J Surg. 2024 Mar 26:S0002-9610(24)00166-1. doi: 10.1016/j.amjsurg.2024.03.006. Online ahead of print.

Authors

Victoria H Chen¹, Keiko M Patterson², Julio Montaner³, Sam M Wiseman⁴

Affiliations

¹ Department of Surgery, University of British Columbia & St. Paul's Hospital, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
² Department of Surgery, University of British Columbia & St. Paul's Hospital, Vancouver, British Columbia, Canada.
³ Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; BC-Centre for Excellence in HIV/AIDS, Providence Health Care & Division of AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
⁴ Department of Surgery, University of British Columbia & St. Paul's Hospital, Vancouver, British Columbia, Canada. Electronic address: smwiseman@providencehealth.bc.ca.

PMID: 38599893
DOI: 10.1016/j.amjsurg.2024.03.006

Abstract

Background: This study aimed to review the varied ^1-4 gastrointestinal (GI) system surgical outcomes among people living with Human Immunodeficiency Virus (PLWH) in the HAART-era.

Methods: MEDLINE and EMBASE were searched for primary publications on GI surgery outcomes exclusively in HAART-treated HIV patients. NSQIP-reported complications (NRCs), all-cause complications (ACC) and HIV disease parameters were extracted.

Results: 12 studies met study inclusion criteria, examining bowel (4), bariatric (5), cholecystectomy (1), appendectomy (1), and other general abdominal operations (1). The NRC rate was 0%, ≥44.4% and 13.3% in bariatric, bowel and appendix surgeries, respectively. Over half of NRCs were infectious. HAART-treated patients had lower ACC, LOS, and sepsis versus untreated-HIV, and higher ACC, LOS and reoperation rates versus HIV-negative patients.

Conclusion: HAART use is associated with markedly improved NRC outcomes post GI surgery among PLWH; however, these remained inferior to those documented among HIV uninfected individuals.

Keywords: HAART; HIV+ HAART; HIV+ surgical outcomes; NSQIP; Surgical outcomes.