Liver resection of metastasis by colorectal cancer in a HIV patient

Liver resection has become the treatment of choice for liver metastasis after colorectal cancer. However, HIV patients have been long denied this chance of cure. The increase in survival of patients with HIV infection is attributed to the use of highly active antiretroviral therapy (HAART). The changes in natural history have prompted the medical community to consider therapeutic strategies including the possibility of major surgery and solid organ transplantation to contrast the clinical picture of end-organ failure or malignancies with a poor prognosis.As results in long-term outcome have not been encouraging, surgeons are not willing to get involved in their management, and both oncologists and infectivologists do not often refer these patients to surgeons. From the advent of HAART to the present, we have treated nine HIV patients of which eight were with major surgery (five orthotopic liver transplants, two liver resections and one head pancreatico-duodenectomy) and one was with a large wound hernia repair.