Operative complications in HIV-infected women undergoing gynecologic surgery

OBJECTIVE: To examine complications in HIV-positive women and controls unde rgoing gynecologic surgery and to evaluate the prognostic value of immune f unction for postoperative morbidity. STUDY DESIGN: A review of patients undergoing surgery by the gynecology fac ulty at the Johns Hopkins Medical Institutions from February 1994 through N ovember 1998 was performed. Fifty-three HIV-positive women were matched wit h 58 controls. Information on demographics, medical conditions, indication for surgery, surgery, blood loss, length of stay, perioperative hemoglobins , postoperative white blood cell counts and complications was collected. Da ta on HIV clinical stage, immune function and Else of HIV medications were collected for HIV-positive patients. Odds ratio and chi (2) or two-sided t tests were used Complication rates were also compared by CD4 counts and by HIV RNA levels. RESULTS: The only difference in demographics was by type of insurance (P < .001). Overall, 9 of 53 HIV-positive women had a complication as compared w ith 5 of 58 controls. There was no difference in the overall rate of compli cations or in specific complications, even when stratified by minor or majo r procedures. There were no differences between CD4 and HIV RNA groups for individual complications. CONCLUSION: The study found no differences in complications between HIV-pos itive and control patients and no association with immune status or viral l oad.