Major surgery seems not to influence HIV disease progression in haemophilia patients

This is the authors' abstract. We don't add key points for this paper.

The influence of major surgery on HIV disease progression and decline in CD4 + cell count was evaluated in 23 seropositive haemophilia patients. 24 HIV‐infected patients served as non‐operated controls. In addition, 32 age‐matched seronegative subjects were included. The follow‐up time was up to 5 years. During the course of the study, eight of the operated (35%) and 11 of the non‐operated (48%) subjects developed HIV‐related symptoms ( P = 0.267). The relative risk for developing HIV‐related symptoms after surgery was 0.60 (95% CI 0.25; 1.48). A significant decline in CD4 + cell counts was observed in both the surgery (4.0 × 10 6 /l/month, 95% CI 2.0; 6.0 × 10 6 , P = 0.001) and the non‐surgery (4.0 × 10 6 /l/month, 95% CI 2.0; 6.0 × 10 6 , P = 0.004) seropositive subgroup, but no difference between the two subgroups was seen ( P = 0.793). HIV (6.0 × 10 6 /l/month, 95% CI 2.1; 9.9 × 10 6 , P = 0.0005) but not surgery (−1.0 × 10 6 /l/month, 95% CI −3.0; 0.96 × 10 6 , P = 0.647) was an independent predictor for the decline in CD34 + cell count. No interaction effect was observed between HIV infection and surgery ( P = 0.361). The annual amount of factor concentrate used for regular replacement therapy did not influence the decline in CD4 + cell count ( P = 0.492). We conclude that major surgery may be considered in symptom‐free HIV‐seropositive haemophilia patients, with CD4 + cell counts 0.20 × 10 9 /l under similar premises as for seronegative subjects.