Is HIV infection a risk factor for complications of surgery?

The literature is inconsistent as to whether HIV-infected patients have higher rates of surgical complication rates than HIV-uninfected patients. This inconsistency reflects the failure to control for confounding variables in many of the previous studies.

A retrospective cohort study of records of HIV-infected individuals who underwent surgical procedures between 1990 and 1995 was matched with the records of HIV-uninfected control patients. We performed a logistic regression analysis to determine the independent effects of HIV infection and other potential risk factors for surgical complications.

The crude rates of death and infectious and hematologic complications were higher among HIV-infected patients than among uninfected patients. Although the crude risk of having any complication was higher among the HIV-infected (odds ratio [OR]=2.47, p=0.015), the adjusted risk was not (OR=0.72 [p<0.613]). Variables significantly associated with complications were American Society of Anesthesiology (ASA) risk class (OR=2.7), age (OR=1.06 per year), and weight (OR=0.96 per kg).

HIV sero-status was not found to be an independent risk factor for complications of surgery. The most important risk factor for complication of surgery in HIV-infected patients is ASA risk class.