ABSTRACT
BACKGROUND: HIV-infected patients are on the increase in Japan, and anti-HIV therapy improved their prognosis. It is expected that the number of operations in HIV patients will increase. METHODS: We surveyed the prevalence of HIV 30,188 patients operated at International Medical Center of Japan, a major, HIV/AIDS hospital, from 2001 to 2007. RESULTS: The number of HIV-positive cases was 389 in 7 years, and the prevalence of HIV seropositivity was 1.3% in total, 1.0% in scheduled, and 2.0% in emergent cases. The prevalence of male (2.0%) was higher than female (0.7%) patients and the prevalence was highest (9.2%) in male patients in their 30's. They were parallel with the HIV occurrence trend of Japan. The prevalence was the highest (2.4%) in the division of general surgery, as well as in obstetric and gynecology. The number of major surgery in HIV patients has been increasing. CONCLUSIONS: We assume that the perioperative management in each hospital has become more important. The annual trend of the number of the operations performed in HIV-positive patients at our hospital did not show annual changes.
Subject(s)
HIV Infections/epidemiology , Hospitals, Public/statistics & numerical data , Surgical Procedures, Operative/statistics & numerical data , Age Factors , CD4 Lymphocyte Count , Female , HIV Infections/diagnosis , Humans , Japan/epidemiology , Male , Mass Screening , Prevalence , Sex Factors , Time FactorsABSTRACT
BACKGROUND: As the number of HIV-infected patients in Japan increases every year, the opportunity for a HIV-positive patient to undergo an operation is also increasing. METHODS: Authors sent questionnaire to 952 anesthesia teaching hospitals, in order to investigate the experience and management of the HIV-positive anesthetic cases. RESULTS: The reply was obtained from 480 teaching hospitals. One hundred and nine hospitals (22.7%) experienced HIV-positive operation, 367 hospitals (76.5%) had no experience. With regard to the number of experienced HIV-positive cases, only one case was the most numerous answer and most of the hospitals had fewer than ten cases. General anesthesia was selected in 74% of cases, regional anesthesia (spinal or/and epidural anesthesia) were selected in 26% of cases. Preoperative HIV examination for almost all scheduled cases were carried out in 24% of the hospitals, but 23% of the hospitals did not carry out the examination at all. Eighteen percent of the hospitals had a severe rule for the management of a HIV-positive case, and 58% of the hospitals had a rule almost the same as for HBV-HCV positive cases. CONCLUSIONS: Almost one fourth of anesthesia teaching hospitals experienced HIV-positive cases. Anesthesiologists should know how to manage HIV-positive surgical patients and be prepared for the cases.
