Reassessing the association between HIV status and post-operative complications in the modern Era

Advances in HIV care have dramatically reduced perioperative mortality, challenging outdated beliefs about worse outcomes for people with HIV (PWH). This study aims to compare odds of developing infections and wound complications in PWH versus non-PWH controls undergoing general surgery.

A data linkage between the British Columbia (BC) HIV-treatment database and hospital administrative data was used to identify PWH, and matched non-PWH who underwent general surgery in BC, Canada between 2008 and 2020. Post-operative infections and wound complications within 30 days were identified using ICD)-9/10 codes.

Among 1252 PWH and 5008 matched non-PWH, HIV status was not significantly associated with post-operative infection (OR:0.95, 95 %CI:0.78-1.16) or wound complications (OR:1.07, 95 %CI:0.19-6.00). However, PWH on income assistance (OR:1.57, 95 %CI:1.26-1.95), with a substance use disorder (OR:1.38, 95 %CI:1.08-1.77) or IV drug use (OR:2.90, 95 %CI:2.28-3.69) had higher odds of post-operative infection.

HIV status alone does not increase the likelihood of post-operative infections or wound complications. However, socioeconomic factors such as being on income assistance and having substance use history likely impact these risks.