SURGERY, SURGICAL PATHOLOGY AND HIV-INFECTION - LESSONS LEARNED IN ZAMBIA

HIV (human immunodeficiency virus) infection is prevalent in many area s of sub-Saharan Africa. Seropositivity rates reach 10-15% in urban ad ults, 21% in critically ill adults and 30% in surgical inpatients aged 21-40 years. AIDS (acquired immune deficiency syndrome) is a multisys tem disease which presents to the surgeon with a wide range of patholo gies including Kaposi's sarcoma, lymphadenopathy and sepsis. The more common sites for sepsis are the female genital tract, anorectum, pleur al cavity, soft tissues (necrotizing fasciitis) and bone and joints. T o prevent iatrogenic HIV infection more use should be made of autologo us blood. Occupational exposure to HIV infection can be minimized by d ouble-gloving, protecting the eyes when operating and ensuring that th eatre gowns are waterproof. The risk of HIV infection from a needlesti ck injury is 0.4%. Although contact with blood during a surgical proce dure is common, the risk is lower than for a hollow needlestick injury .