Wednesday, July 26, 2006

LVRS contra-indication

This question came up recently on this patient's follow-up. This is a relatively young man with HIV/AIDS who has done remarkably well on HAART (he had PCP 8 years ago!). He has the typical bullous emphysema associated with HIV and his previous smoking history. His emphysema is predominantly upper lobe (see below with a nice azygous "lobe"), he is hyperinflated and has air trapping. His FEV1 is still greater than 45% so LVRS is not for him yet anyway.
However, the question came up, is HIV infection an absolute contra-indication to LVRS?

2 comments - CLICK HERE to read & add your own!:

Jennings said...

I could not find anything regarding HIV being a contraindication for LVRS. It is of course an absolute contraindication for transplant due to the immunosuppressive regimen. Since LVRS does not require post-op immunosuppressives, I would expect that it would be only a relative contraindication at worse, or no contraindication at best.

Arenberg said...

In the strictest sense it is, because the original NETT trial excluded patients with HIV infection.