An anesthesiologist’s view of problems in HIV-positive patients

  • E. V. Grigimalsky Maternity Hospital “Leleka”, Kyiv
  • A. I. Garga Maternity Hospital “Leleka”, Kyiv
  • A. V. Tarasov Maternity Hospital “Leleka”, Kyiv
  • I. N. Dovgiy Maternity Hospital “Leleka”, Kyiv
  • N. N. Budnyk Maternity Hospital “Leleka”, Kyiv
Keywords: HIV infection, perioperative period, treatment, patient, caesarean section


Currently, HIV infection is becoming epidemic. More than 42% of HIV-infected people in the world are women of childbearing age. With the onset of antiretroviral therapy, chemoprophylaxis during pregnancy, and planned cesarean section, the risk of perinatal HIV transmission decreases to 1–2%. However, various side effects such as anemia, neutropenia, thrombocytopenia, fatty liver dystrophy, toxic hepatitis, acute pancreatitis, increased serum transaminases, changes in biochemical parameters of liver function, impaired glucose tolerance, and hypocoagulation may occur in the context of antiretroviral therapy. This poses to the anesthesiologist a number of new tasks to ensure patient safety during the perioperative period.


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Lorenzi P, Spicher VM, Laubereau B, Hirschel B, Kind C, Rudin C, et al. Antiretroviral therapies in pregnancy: maternal, fetal and neonatal effects. Swiss HIV Cohort Study, the Swiss Collaborative HIV and Pregnancy Study, and the Swiss Neonatal HIV Study. AIDS. 1998 Dec 24;12(18):F241-7.

Garcia PM. Maternal Toxicity and Pregnancy Complications in Human Immunodeficiency Virus–Infected Women Receiving Antiretroviral Therapy: PACTG 316. Yearbook of Obstetrics, Gynecology and Women’s Health [Internet]. Elsevier BV; 2006 Jan;2006:99–100. Available from:

De Andrade CM, Duarte G, Quintana SM, Montes MBA, Toloi MRT. Effect of antiretroviral therapy on hemostasis in Brazilian pregnant women with HIV infection. Blood Coagulation & Fibrinolysis [Internet]. Ovid Technologies (Wolters Kluwer Health); 2007 Dec;18(8):769–74. Available from:

Fabricius EM, Schramm W, Goebel FD, Schmitz K, Patzak A, Hammel G // International Conference on AIDS. Fibrinolysis and endothelin in retinal and conjunctival microangiopathy in HIV-infection // IntConf AIDS. 2002 Jul. 19–24; 8: 77 (abstract no. PuB 7172).

Omoregie R, Adeghe JE, Ogefere HO, Omokaro EU, Ekeh CC. Haemorheologic and fibrinolytic activity in Nigerian HIV infected. African health sciences. 2008;8(4):217-9.

SWINDELLS S, ZHENG J, GENDELMAN HE. HIV-Associated Dementia: New Insights into Disease Pathogenesis and Therapeutic Interventions. AIDS Patient Care and STDs [Internet]. Mary Ann Liebert Inc; 1999 Mar;13(3):153–63. Available from:

Crane HM, Van Rompaey SE, Kitahata MM. Antiretroviral medications associated with elevated blood pressure among patients receiving highly active antiretroviral therapy. AIDS [Internet]. Ovid Technologies (Wolters Kluwer Health); 2006 Apr;20(7):1019–26. Available from:

Evron S, Glezerman M, Harow E, Sadan O, Ezri T. Human Immunodeficiency Virus: Anesthetic and Obstetric Considerations. Anesthesia & Analgesia [Internet]. Ovid Technologies (Wolters Kluwer Health); 2004 Feb;503–11. Available from:

Turjanski N, Lloyd GG. Psychiatric side-effects of medications: recent developments. Advances in Psychiatric Treatment [Internet]. Cambridge University Press (CUP); 2005 Jan;11(1):58–70. Available from:

Hignett R, Fernando R. Anesthesia for the Pregnant HIV Patient. Anesthesiology Clinics [Internet]. Elsevier BV; 2008 Mar;26(1):127–43. Available from:

Treisman GJ, Kaplin AI. Neurologic and psychiatric complications of antiretroviral agents. AIDS [Internet]. Ovid Technologies (Wolters Kluwer Health); 2002 Jun;16(9):1201–15. Available from:

Avidan MS, Groves P, Blott M, Welch J, Leung T, Pozniak A, et al. Low Complication Rate Associated with Cesarean Section under Spinal Anesthesia for HIV-1–Infected Women on Antiretroviral Therapy. Anesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 2002 Aug;97(2):320–4. Available from:

Bremerich DH, Ahr A, Buchner S, Hingott H, Kaufmann M, Faul-Burbes C, et al. Anethesiologische Versorgung von HIV-positiven Schwangeren zur elektiven Sectio caesarea. Der Anaesthesist [Internet]. Springer Science and Business Media LLC; 2003 Dec 1;52(12):1124–31. Available from:

Kuczkowski KM. Anesthetic Considerations for the HIV-Infected Pregnant Patient. Yonsei Medical Journal [Internet]. Yonsei University College of Medicine (KAMJE); 2004;45(1):1. Available from:

How to Cite
Grigimalsky EV, Garga AI, Tarasov AV, Dovgiy IN, Budnyk NN. An anesthesiologist’s view of problems in HIV-positive patients. prmd [Internet]. 2018May16 [cited 2019Jul.22];1(1):66-9. Available from:
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