Infective complications after minor operations in patients infected with HIV: role of CD4 lymphocytes in prognosis.
OBJECTIVE
To find out the incidence of wound infection in patients with HIV and reduced counts of CD4 lymphocytes.


METHODS
Open study.


METHODS
University hospital, Spain.


METHODS
70 patients with HIV infection and enlarged lymph nodes.


METHODS
Biopsy of lymph nodes and withdrawal of a sample of blood for counts of CD4 lymphocytes and neutrophils.


METHODS
Development of infection at the biopsy site, and correlation of infecting organism with culture taken at the time of biopsy.


RESULTS
Patients were divided into three groups depending on their CD4 count: more than 500 cells/ml (n = 26), 200-500 cells/ml (n = 24), and less than 200 cells/ml (n = 20). Their neutrophil counts were 5.1, 3.8, and 2.5 x 10(9)/1, respectively. There were found four wound infections (6%); 2 were in the group with more than 500 CD4 cells/ml, and these were caused by Staphylococcus aureus (which had been grown from nodes in 6 patients at the time of biopsy). The other 2 were in the group with less than 500 cells/ml and these were caused by Mycobacterium tuberculosis; cultures of the nodes had shown Staphylococcus epidermidis (n = 3) and M tuberculosis (n = 17). There were no infections in the group with 200-500 CD4 cells/ml, in which S epidermidis (n = 5) and M tuberculosis (n = 8) had been cultured from the lymph nodes.


CONCLUSIONS
The CD4 count was of no prognostic importance in the development of wound infection, but severe depression of the CD4 count may increase the risk of atypical wound infections.
Emparan
C
C
Department of Surgery, Universidad del Pais Vasco, General Surgery B, Hospital de Basurto, Bilbao, Spain.
Iturburu
I M
IM
Portugal
V
V
Apecechea
A
A
Bilbao
J E
JE
Mendez
J J
JJ
D001706:Biopsy; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000502:physiology*; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D007958:Leukocyte Count; D008198:Lymph Nodes / Q000382:microbiology / Q000473:pathology; D009504:Neutrophils; D011379:Prognosis; D013203:Staphylococcal Infections / Q000276:immunology / Q000382:microbiology; D013530:Surgical Wound Infection / Q000276:immunology* / Q000382:microbiology; D014376:Tuberculosis / Q000276:immunology / Q000382:microbiology