Human immunodeficiency virus in chronic limb-threatening ischaemia: Risk factors, management, and outcomes: A South African retrospective cohort study

Journal of the Colleges of Medicine of South Africa

 
 
Field Value
 
Title Human immunodeficiency virus in chronic limb-threatening ischaemia: Risk factors, management, and outcomes: A South African retrospective cohort study
 
Creator Corbett, Craig Louwrens, Helene Esterhuizen, Tonya M. Germishuys, Daniel C. Hayes, Reinhard
 
Subject Vascular Surgery; Surgery; Cardiovascular Medicine; Infectious Diseases; HIV Medicine; Epidemiology; Global Health HIV; chronic limb-threatening ischaemia; prevalence; risk factors; outcomes
Description Background: People living with human immunodeficiency virus (PLHIV) have an increased risk of chronic limb-threatening ischaemia (CLTI), yet data from sub-Saharan Africa in the modern antiretroviral era remain limited. We estimated the human immunodeficiency virus (HIV) prevalence in patients admitted with index CLTI and compared risk factors and outcomes with those of their seronegative counterparts.Methods: Retrospective study of adults admitted with CLTI to Tygerberg Hospital (2016–2022). Patients identified via discharge summaries were corroborated with medical records. Clinical and HIV status data were extracted from medical and laboratory records.Results: Among 1205 patients admitted with index CLTI, the estimated prevalence of HIV was 3.5% (95% CI: 2.5% – 4.7%), with 588 confirmed HIV-negative (48.8%) and 575 with unknown HIV status (47.7%). The PLHIV cohort was 69% male compared to 64% in the HIV-negative group (p = 0.511). The mean age of PLHIV with CLTI was 51 years (± 9 years) compared to 62 years (± 11 years) (p 0.001). People living with human immunodeficiency virus were less than half as likely to undergo endovascular therapy as their definitive management although not statistically significant (7.1% vs 17.8%; odds ratios: 0.49, 95% CI: 0.13–1.93, p = 0.305). A similar proportion of PLHIV and HIV-negative patients underwent open revascularisation (23.8% vs 22.8%, p = 0.652). Surgical management had similar rates of successful outcomes (defined as below ankle amputation or better, 90% vs 95.5%, p = 0.433). We found no difference in in-hospital mortality rates.Conclusion: People living with HIV were younger and had fewer risk factors for CLTI than their HIV-negative counterparts. In-hospital revascularisation outcomes, complication rates and mortality were similar.Contribution: Further study is needed regarding the district hospital HIV burden and long-term outcomes in these patients.
 
Publisher AOSIS
 
Contributor
Date 2026-03-27
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — retrospective descriptive study
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/jcmsa.v4i1.321
 
Source Journal of the Colleges of Medicine of South Africa; Vol 4, No 1 (2026); 8 pages 2960-110X 3105-4331
 
Language eng
 
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The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://jcmsa.org.za/index.php/jcmsa/article/view/321/976 https://jcmsa.org.za/index.php/jcmsa/article/view/321/977 https://jcmsa.org.za/index.php/jcmsa/article/view/321/978 https://jcmsa.org.za/index.php/jcmsa/article/view/321/979
 
Coverage South Africa, Cape Town January 2016 to December 2022 The study population comprised adult patients (≥18 years) admitted with index chronic limb-threatening ischaemia (CLTI) to the Vascular Surgery Department at Tygerberg Hospital, a tertiary referral centre in Cape Town, South Africa
Rights Copyright (c) 2026 Craig Corbett, Helene Louwrens, Tonya M. Esterhuizen, Daniel C. Germishuys, Reinhard Hayes https://creativecommons.org/licenses/by/4.0
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