HIV, Especially With Low CD4s, Raises Post-Surgery Death Rates
HIV-positive people on antiretroviral (ARV) treatment have a low overall risk of death following surgery, but it is still higher on average than those without the virus, in particular if CD4 counts are low, ScienceDaily reports. However, age and proper nutrition are just as important as immune status when figuring the likelihood of death. Publishing their findings in JAMA Surgery, researchers analyzed medical records data from the U.S. Veterans Health Administration Healthcare System from 1996 to 2010, comparing post-operative death rates among 1,641 HIV-positive people on ARVs with those of 3,282 HIV-negative people matched by what kind of operation they had.

The HIV-positive individuals had a 3.4 percent death rate during the 30 days after surgery, compared with 1.6 percent among the HIV-negative group. This meant that having HIV was associated with a 2.11 times greater likelihood of death during that month-long period. After adjusting for various factors, the researchers found that, when compared with the HIV-negative group, those in the HIV-positive group who had 500 or more CD4 cells were 1.92 times more likely to die; those with 200 to 499 CD4s were 1.89 times more likely to die; those with 50 to 199 CD4s were 2.66 times more likely to die; and those with fewer than 50 CD4s were 6.21 times more likely to die.

Meanwhile, those with poor nutrition (hypoalbuminemia) were 4.35 times as likely to die as those who were well-nourished. Each additional decade of age was linked to a 47 percent increase in the likeliness of post-operative death.