Cardiac surgery in human immunodeficiency virus (HIV) carriers

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Intravenous drug abuse is a significant risk factor for infective endocarditis.
• Co-infection with human immunodeficiency virus (HIV) is prevalent among intravenous drug users.
• Open cardiac surgery is a treatment option for infective endocarditis.

Purpose of the Study:

• To evaluate the outcomes of open cardiac surgery for infective endocarditis in HIV-positive patients.
• To compare surgical outcomes in HIV-positive patients with active infection versus those cured by antibiotics.
• To assess outcomes in HIV-positive patients compared to a pre-HIV era cohort.

Main Methods:

• Retrospective analysis of 11 HIV-positive patients undergoing open cardiac surgery for endocarditis.
• Comparison of outcomes based on the presence of active infection at surgery.
• Comparison with 10 HIV-negative patients from the pre-HIV era.

Main Results:

• Four of 7 HIV-positive patients with active infection died within 2 months due to sepsis.
• HIV-positive patients without active infection at surgery had good outcomes.
• Patients cured by antibiotics but with valve damage also had good surgical outcomes.

Conclusions:

• Persistent sepsis in HIV-positive endocarditis patients indicates a poor prognosis, likely due to immune compromise.
• HIV-positive patients without active infection tolerate open cardiac surgery well.
• Risks of HIV progression post-surgery and transmission to surgical teams remain unknown and require further investigation.