ArticleTherapeutic advances in urology
Efficacy and postoperative outcomes of kidney stone surgery in HIV-positive patients: A retrospective cohort study.
Article in Therapeutic advances in urology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: People living with HIV (PLWH) are increasingly undergoing endourological procedures, including mini-percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS), but comparative evidence on postoperative infectious outcomes is limited. Objectives: This study aims to compare short-term postoperative outcomes between PLWH and HIV-negative patients undergoing mini-PCNL or RIRS, focusing on postoperative urosepsis and exploring factors associated with urosepsis among PLWH. Design: A single-center, retrospective cohort study. Methods: Consecutive adult patients who underwent mini-PCNL or RIRS between July 2023 and January 2025 were grouped by HIV status. The primary outcome was postoperative urosepsis during the index hospitalization. Secondary outcomes included stone-free status and length of stay. Results: A total of 708 patients were included (70 PLWH and 638 HIV-negative). Postoperative urosepsis occurred in 8/70 (11.4%) PLWH and 45/638 (7.1%) HIV-negative patients, with no significant difference between groups (p=0.13). Stone-free status was achieved in 66/70 (94.3%) PLWH and 586/638 (91.8%) HIV-negative patients (p=0.48). Other outcomes, including total hospitalization time, postoperative hospital stay, and preoperative antibiotic exposure, did not differ significantly between groups (all p>0.05). Among PLWH, exploratory univariable analyses showed that female sex, positive preoperative urine culture, and clinically higher-risk HIV disease group (acute HIV infection or AIDS) were associated with higher odds of postoperative urosepsis. CD4+ T-cell count <400 cells/µL showed a higher but statistically non-significant estimated odds. Conclusion: Short-term postoperative outcomes following mini-PCNL or RIRS did not differ significantly between PLWH and HIV-negative patients. Exploratory univariable analyses suggested that female sex, positive preoperative urine culture, and clinically higher-risk HIV disease group were associated with postoperative urosepsis among PLWH. These findings should be interpreted cautiously because of the limited number of PLWH and urosepsis events.
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