Surgery in the immunocompromised patient

Abstract

It is currently estimated that more than 40 million people worldwide are infected with the human immunodeficiency virus (HIV). Although there is no end in sight to the epidemic, current therapeutics have significantly altered the course of the illness. HIV-infected people are much more likely to live longer, less likely to die of opportunistic infections, and more likely to present to the surgical community with relatively well-preserved immune function. Physicians must be not only armed with knowledge on how to protect themselves from inadvertent infection but possess a basic understanding of the disease process and treatment. Patients present with malignancies, end-organ failures, and treatment-related toxicities as well as those illnesses expected in any adult population regardless of immune function. Surgical intervention is routine, and outcome will be influenced by how well we define preoperative risk and understand optimum perioperative management. © 2008 Springer New York.