HIV and surgical approach: advanced strategies for preventing infections and post-transplant complications

Abstract

HIV, a Lentivirus retrovirus, compromises the immune system by targeting CD4+ T lymphocytes, leading to immunosuppression and chronic disease predisposition. Markers like CD4+ count and viral load are key to managing the infection. Immunosuppressive therapies increase risks such as graft rejection and cancer, especially in surgical settings, highlighting the need for effective strategies to mitigate risks and improve outcomes. The review analyzed studies from the past 20 years on strategies to reduce post-transplant complications in HIV-positive patients. Articles focusing on transplants and complex surgeries, evaluating interventions like prophylactic antibiotics and antiretroviral therapy management, were included. Irrelevant or clinically weak studies were excluded. Trends and gaps in managing complications were highlighted, with recommendations for tailored clinical practices and multidisciplinary approaches. From 120 studies, 7 were included for final analysis. Evidence shows prolonged immunosuppression increases susceptibility to infections and cancer, while advanced management regimens effectively control HIV and postoperative complications. Recent studies emphasize innovative strategies, such as immunological tolerance induction and ex vivo perfusion, to reduce rejections and optimize treatments. Kidney transplant outcomes showed promising survival rates despite challenges like acute rejections and drug interactions. Significant progress has been made in managing HIV-positive patients, yet challenges like frequent rejections and adverse effects from prolonged immunosuppression remain. Immunological tolerance induction is not yet widely applicable, and further research is critical to develop effective, personalized strategies. Emphasis on emerging therapies, predictive markers, and multidisciplinary approaches is crucial to enhance quality of life and survival.