**10. Prognosis and outcome**

HIV patients with low CD4 counts, hyperglobulinemia, hypoalbuminemia and reversed CD4/CD8 ratios were reported have worse prognosis in a study by Van Marle et al. [26]. For peripheral large vessel surgery the perioperative mortality was reported to be between 9 and 10.6% in South Africa and 33% in Houston [5]. Major challenges related to wound healing and infection. Late graft sepsis rate of 10% has been reported with the use of prosthetic grafts. The follow-up in the aforementioned studies was poor and presents a major challenge in reporting long term outcomes. Further, the results may vary between patients on HAART compared to those without HAART. There are no studies pertaining to surgery in patients with ascending aortic aneurysms and descending thoracic aneurysms in the setting of HIV. No current studies address the natural history of HIV associated ascending or descending aortic aneurysms.
