Human immunodeficiency virus in total hip arthroplasty.

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Public Health

Background:

• Human immunodeficiency virus (HIV) is a global pandemic impacting millions.
• Increased longevity due to highly active antiretroviral treatment (HAART) leads to degenerative joint conditions in HIV patients.
• HIV and HAART independently increase the need for total hip arthroplasty (THA) and predispose patients to avascular necrosis and fractures.

Purpose of the Study:

• To review the association between HIV and THA.
• To identify patient risk factors for optimizing functional outcomes.
• To decrease revision rates in HIV-positive patients undergoing THA.

Main Methods:

• Literature review of studies on HIV and THA.
• Analysis of risk factors and outcomes.
• Comparison of outcomes in HIV-positive versus HIV-negative patients on HAART.

Main Results:

• Prior to HAART, HIV-positive patients had higher complication rates after THA.
• Current literature shows comparable functional outcomes and survival rates for HIV-positive patients on HAART versus HIV-negative controls.
• Periprosthetic joint infection (PJI) risk is mitigated by HAART and viral suppression.

Conclusions:

• THA should not be withheld from HIV-infected patients.
• Pre-operative assessment and optimization of comorbidities and HAART are crucial.
• Identifying and treating HIV with HAART can prevent peri-operative complications.