SPLENECTOMY IN PATIENTS WITH AIDS AND AIDS-RELATED COMPLEX

Objective: To study the effect of splenectomy in HIV-infected patients . Design: A retrospective chart review of patients admitted to St Vinc ent's Hospital who had splenectomies and were HIV-positive. Setting: A ll patients were treated at St Vincent's Hospital, New York City, New York, USA. Patients: Only patients who were HIV-positive and who had h ad a splenectomy at St Vincent's Hospital were included. Intervention: All patients had a splenectomy. Main outcome measures: The effect of the splenectomy in these HIV-positive patients was studied with respec t to their operative morbidity and mortality, platelet counts, overall survival and the development of new opportunistic infections. Results : All patients who did not have AIDS but did have thrombocytopenia res ponded to splenectomy in terms of their thrombocytopenia. None of them had an accelerated progression to AIDS. Most patients with AIDS and t hrombocytopenia responded to splenectomy in terms of correcting their thrombocytopenia. Conclusions: Splenectomy as a treatment for thromboc ytopenia is successful not only in HIV-positive patients without AIDS, but also in AIDS patients. However, in patients with disseminated Kap osi's sarcoma or Mycobacterium avium intracellulare, splenectomy may n ot be a factor for survival.