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Radiologic insertion of Hickman catheters in HIV-positive patients: infectious complications
L Dick1, M A Mauro, P F Jaques
1Department of Radiology, University of North Carolina Hospitals, Chapel Hill 27599-7510.
Insights
Hickman catheter placement is safe for patients with human immunodeficiency virus (HIV). Infectious complication rates were similar between HIV-positive and HIV-negative patients, supporting its clinical use.
Area of Science:
- Medical Devices
- Infectious Diseases
- Oncology
Background:
- Hickman catheters are crucial for long-term venous access in various medical conditions.
- Assessing infectious complication risks in human immunodeficiency virus (HIV)-positive patients is vital for safe device utilization.
Purpose of the Study:
- To compare infectious complication rates associated with radiologically guided Hickman catheter placement between HIV-positive and HIV-negative patients.
Main Methods:
- Retrospective analysis of 104 Hickman catheter placements in 96 patients, categorized by HIV serologic status.
- Infectious complications were classified by severity (local/systemic) and timing (periprocedural/late).
- Infection rates were calculated per 100 indwelling catheter days.
Main Results:
- 14 placements in HIV-positive patients had a 14% infection rate (0.18 complications/100 catheter days).
- 90 placements in HIV-negative patients had a 10% infection rate (0.19 complications/100 catheter days).
- No statistically significant difference in infectious complication rates was observed between the two groups (RR 1.4, 95% CI).
Conclusions:
- Radiologically guided Hickman catheter placement demonstrates comparable safety profiles in HIV-positive and HIV-negative patients regarding infectious complications.
- The findings support the clinical utility of Hickman catheters in HIV-positive individuals.
- Further studies with larger cohorts of HIV-positive patients are recommended to confirm these results with greater statistical power.
Abstract:
Ninety-six patients undergoing radiologically guided placement of 104 Hickman catheters were grouped according to their human immunodeficiency virus (HIV) serologic status. Infectious complications were categorized according to their severity (local or systemic) and time of occurrence (periprocedural or late). The number of infectious complications per 100 indwelling catheter days was calculated. Among the 14 catheter placements in 13 HIV-positive patients, two systemic infections occurred, resulting in a 14% overall infection rate and 0.18 infectious complications per 100 indwelling catheter days. The remaining 83 HIV-negative patients underwent 90 Hickman catheter placements. Nine infectious complications (10%) were noted in the 90 catheters, translating into 0.19 infectious complications per 100 indwelling catheters days. These results suggest no significant (relative risk [RR] of 1.4 and .95) difference in infectious complication rates encountered in HIV-positive patients compared with the general population. This supports the clinical usefulness of Hickman catheter placement in HIV-positive patients, although many additional HIV-positive patients must be evaluated to achieve an acceptable level of statistical confidence.