General surgery in the patient with AIDS.

In 1993, it is estimated that 2 million Americans are infected with the human Immunodeficiency Virus (HIV). The Acquired Immune Deficiency Syndrome (AIDS) represents the most severe manifestation of infection with the virus. In the patient with AIDS, helper T lymphocytes are depleted resulting in a defect in cell mediated immunity. The resulting state of profound immunosuppression leads to susceptibility to rare infections and tumors. Although opportunistic infections have been seen in patients on immunosuppressive therapy, those associated with AIDS are much more severe and extensive. Many patients present with symptoms that mimic acute surgical emergencies. In other cases, the presentation has been one of a more chronic disease state. Some of the diseases associated with AIDS are directly attributable to the effects of the HIV virus. In all of these categories, there are some patients who will benefit from surgical therapy. In many cases medical therapy will be more appropriate. The evaluation of these patients can represent a major diagnostic challenge to the surgeon. A familiarity with these disease processes is essential for timely diagnosis and appropriate treatment.