Outcomes of varicose vein surgery in patients with HIV/AIDS – a nested case-control study

Authors

  • António Pereira-Neves Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Biomedicine – Unit of Anatomy, Faculdade de Medicina da Universidade do Porto, Portugal https://orcid.org/0000-0003-0209-7670
  • Diogo Domingues-Monteiro Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal https://orcid.org/0000-0001-9324-0131
  • Leandro Nóbrega Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal https://orcid.org/0000-0003-2650-324X
  • Luís Duarte-Gamas Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal https://orcid.org/0000-0002-9271-1170
  • Alfredo Cerqueira Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal https://orcid.org/0000-0003-0736-3579
  • João Rocha-Neves Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Biomedicine – Unit of Anatomy, Faculdade de Medicina da Universidade do Porto, Portugal https://orcid.org/0000-0002-2656-8935
  • José Oliveira-Pinto Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal https://orcid.org/0000-0002-6254-8069
  • Armando Mansilha Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal https://orcid.org/0000-0002-6722-0476

DOI:

https://doi.org/10.48750/acv.492

Keywords:

HIV/AIDS care, chronic venous disease, varicose veins, venous surgery

Abstract

INTRODUCTION: Currently, people living with HIV/ AIDS (PLWHA) attain a life expectancy similar to a non-HIV population. However, these patients experience a status of chronic inflammation, which is a known cause of arteriopathy. Yet, literature is scarce regarding the potential venous inflammatory effect, especially after varicose vein surgery. The aim of this study was to perform a descriptive analysis alongside evaluating short and long- term outcomes after varicose vein surgery in PLWHA while comparing with a control group.

METHODS: A retrospective nested case-control study was performed resorting to codification. All PLWHA patients which had any hospital interaction with the Vascular Surgery Department (either outpatient clinic, emergency or surgery) due to venous disease between April 2006 and December 2019 were identified. PLWHA found to have undergone varicose vein surgery within the study inclusion period were included. The immediately consecutive varicose vein surgery in a patient with no-HIV infection was included in the control group in a 1:1 ratio. Comorbidities were collected at the time of index event.

RESULTS: The cohort included 118 patients (59 PLWHA and 59 control) and had a mean follow-up of 86 [Interquartile range (IQR) 25-75%, 43-111] months. At baseline, PLWHA were younger (45.2 ± 10.71 vs 49.9 ± 10.69 years, p=0.017) and had a male predominance (54% vs 27%, p=0.003). Furthermore, there were a higher prevalence of smokers (54% vs 17%, p<0.001) and history of drug abuse (34% vs 2%, p<0.001) in the study group. Although not statistically significant, PLWHA presented higher pre-operative CEAP classifications. Regarding post-operative outcomes, no differences were found for complications, reinterventions or overall-mortality.

CONCLUSION: To the authors knowledge, this is the first study addressing varicose vein treatment in PLWHA. In summary, PLWHA undergoing varicose vein surgery seem to be younger and have higher CEAP classifications. Nonetheless, short and long-term outcomes seem to be good and similar to a control population. Further studies with larger populations and disease specific outcomes are necessary to confirm such findings.

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References

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Published

2023-03-23

How to Cite

1.
Pereira-Neves A, Domingues-Monteiro D, Nóbrega L, Duarte-Gamas L, Cerqueira A, Rocha-Neves J, Oliveira-Pinto J, Mansilha A. Outcomes of varicose vein surgery in patients with HIV/AIDS – a nested case-control study. Angiol Cir Vasc [Internet]. 2023 Mar. 23 [cited 2024 Jul. 13];18(4):215-8. Available from: https://acvjournal.com/index.php/acv/article/view/492

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Original Article