Safety of medical male circumcision in human immunodeficiency virus-infected men in rakai, Uganda

January 31, 2014 by
RHSP

Kigozi G, Musoke R, Kighoma N, Kiwanuka N, Makumbi F, Nalugoda F, Wabwire-Mangen F, Serwadda D, Wawer MJ, Gray RH.

Urology. 2014 Feb;83(2):294-7. doi: 10.1016/j.urology.2013.08.038. Epub 2013 Nov 26. PMID: 24286598


Abstract

Objective: 

To assess the safety of medical male circumcision (MMC) among human immunodeficiency virus (HIV)-infected men with CD4 levels <350 cells/mm(3), CD4 counts ≥ 350 cells/mm(3), and HIV-negative men.

Methods: 

Two hundred forty-two HIV-infected men and a sample of 262 HIV-negative consenting men aged 12 years or older who requested free MMC were enrolled in a prospective study. Blood for HIV testing and a CD4 count were collected before surgery. During weekly follow-up over 6 weeks, data were collected on wound healing and adverse events (AEs) by examination, and resumption of sex and condom use ascertained by interview. Surgery-related AEs were characterized by type, severity, management, and resolution. Chi-square and Fisher's exact tests were used to test for differences in AE proportions.

Results: 

Overall, only 2 of the 453 men experienced moderate AEs, a rate of 0.44 per 100 surgeries. No AE occurred among HIV-negative men, whereas the AE rate among HIV-infected men with CD4 counts ≥ 350 cells/mm(3) was 0.79 per 100 surgeries, and among men with CD4 counts <350 cells/mm(3) the rate was 1.19 per 100 surgeries (P = .214). AE rates were comparable for all characteristics (P >.05).

Conclusion: 

HIV-positive men can be safely included in MMC roll out programs without necessitating presurgery CD4 counts determination.

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