The attitudes of British surgical trainees about the treatment of HIV-infected patients

Hindocha, Sandip

doi:10.1007/s00595-011-0096-2

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…In the pre-HAART era, 74% of orthopedic surgeons reported at least moderate concern about occupational acquisition of HIV (71). Even in the era of widespread HAART in which there have been no documented cases of HIV transmission to surgeons (72, 73), concern over HIV acquisition during surgery persists in over half (54%) of trainees, in whom only a fraction (16%) is aware of the minimal risk conferred by needlestick injury (74). There may also be perceived increased risk of wound infections or other negative surgical outcomes associated with co-morbid HIV infection.…”

Section: Discussionmentioning

confidence: 99%

Are HIV-Infected Men Vulnerable to Prostate Cancer Treatment Disparities?

Bhatia

Martin

Klein

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background HIV-infected (HIV+) men face cancer treatment disparities which impact outcome. Prostate cancer (PCa) treatment and treatment appropriateness in HIV+ men are unknown. Methods We used electronic chart review to conduct a retrospective cohort study of 43 HIV+ cases with PCa and 86 age- and race-matched HIV-uninfected (HIV−) controls with PCa, aged 40–79, from 2001–2012. We defined treatment appropriateness using National Comprehensive Cancer Network (NCCN) guidelines and the Charlson Co-morbidity Index (CCI) to estimate life expectancy. Results Median age was 59.5 years at PCa diagnosis. Median CD4+ T-cell count was 459.5cells/mm3, 95.3% received antiretroviral therapy, and 87.1% were virally suppressed. Radical prostatectomy (RP) was the primary treatment for 39.5% of HIV+ and 71.0% of HIV− men (p= 0.004). Only 16.3% of HIV+ vs. 57.0% of HIV− men received open RP (p< 0.001). HIV+ men received more radiotherapy (25.6% vs. 16.3%, p= 0.13). HIV was negatively associated with open RP (OR= 0.03, p= 0.007), adjusting for insurance and CCI. No men were undertreated. Fewer HIV+ men received appropriate treatment (89.2% vs. 100%, p= 0.003), due to 4 overtreated HIV+ men. Excluding AIDS from the CCI still resulted in fewer HIV+ men receiving appropriate treatment (94.6% vs. 100%, p = 0.03). Conclusion PCa in HIV+ men is largely appropriately treated. Under-or overtreatment may occur from difficulties in life expectancy estimation. HIV+ men may receive more radiotherapy and fewer RPs, specifically open RPs. Impact Research on HIV/AIDS survival indices and etiologies and outcomes of this PCa treatment disparity in HIV+ men is needed.

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Section: Discussionmentioning

confidence: 99%