Do HIV-positive patients achieve successful outcomes in elective orthognathic osteotomies?: A case series

This case series evaluates the impact of well-controlled human immunodeficiency virus (HIV) on the success of elective orthognathic osteotomies.

A retrospective review of HIV-positive patients undergoing elective orthognathic osteotomies was conducted. Inclusion criteria required patients to have an HIV diagnosis, undergo orthognathic surgery, and be treated with ART, leading to well-controlled HIV (viral load below 200 copies/mL). Those with incomplete records were excluded. Study variables were grouped into demographic (e.g., age, sex, dentofacial deformity), HIV-specific (e.g., viral load, CD4 count), and operative (e.g., procedure type). Perioperative management included continued antiretroviral therapy (ART), antibiotic prophylaxis, and strict infection control.

Three patients (aged 34-59) with well-controlled HIV underwent Le Fort osteotomy and bilateral sagittal split osteotomy (BSSO). Two had developmental dentofacial deformities, one was post-traumatic. Two Le Forts were 2-piece, one was 3-piece; 2 patients had BSSO. All showed successful bone healing without increased infection or nonunion rates post-allogenic bone grafts.

Well-managed HIV-positive patients can achieve successful outcomes in elective orthognathic osteotomies, comparable to those in HIV-negative individuals. The small sample limits generalizability, warranting further research to assess long-term outcomes and refine perioperative guidelines.