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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 1999 Agosto;40(4):477-9

lingua: Inglese

Sig­nif­i­cance of the ­human immu­no­def­i­ciency ­virus infec­tion in ­patients sub­mitted to car­diac sur­gery

Everson Uip D., Zeigler R., Sabbaga Amato M., Varejao Strabelli T. M., Aranha Camargo L. F., Grinberg M.*, Domingos Jatene A.**

From the Depart­ment of Epi­dem­i­ology and ­Quality Con­trol
* Hos­pital Infec­tion Con­trol Commis­sion
** Sur­gery Depart­ment and from the ­Heart Insti­tute Insti­tuto do ­Coração do Hos­pital das ­Clínicas da Facul­dade de Med­i­cina da Uni­ver­si­dade de São ­Paulo, Brazil


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Back­ground. To ­realize if car­diac sur­gery ­could inter­fere ­with the evo­lu­tion of HIV ­infected ­patients to the ­acquired immu­no­def­i­ciency syn­drome (­AIDS).
­Methods. The ­study ­group con­sisted of 30 HIV pos­i­tive ­patients (0.21%) ­among 14,785 who under­went car­diac sur­gery at the ­Heart Insti­tute of Uni­ver­sity of São ­Paulo Med­ical ­School (­Incor-­FMUSP) ­from ­November 1988 to ­December 1994. ­Patients ­were fol­lowed up ­until ­they ­were dis­charged ­from hos­pital and a new con­tact was ­kept at the end of the ­first ­semester of 1995.
­Results. All ­patients ­were asymp­to­matic at the ­time ­they ­were oper­ated. Two ­patients pro­gressed to ­death ­during hos­pi­tal­iza­tion due to non-infec­tious com­pli­ca­tions and ­other ­three ­patients ­could not be ­traced. ­After all, 25 ­pa-tients had ­their pro­gres­sion eval­u­ated. Six ­patients (24%) ­died ­within a ­period ­ranging ­from 1 to 46 ­months (average=17 ­months): 2 due to bac­te­rial pneu­monia and 04 due to ­AIDS-­related com­pli­ca­tions. The ­average ­follow-up ­period for the 19 sur­viving ­patients was 33.6 ­months (­ranging ­from 13 to 74 ­months), and ­only one of ­them (5.3%) saw the infec­tion ­progress to ­AIDS. In sum­mary, 5/25 (20%) saw HIV infec­tion ­progress to ­AIDS ­within a max­imum ­period of 74 ­months.
Con­clu­sions. ­Data avail­able up to now ­show no con­clu­sive evi­dence of accel­er­a­tion of HIV ­into ­AIDS asso­ciated ­with car­diac sur­gery.

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