Preoperative counts of CD4 T-lymphocytes and early postoperative infective complications in HIV-positive patients.
OBJECTIVE
To assess the relationship between postoperative infective complications and the CD4 count.


METHODS
Retrospective and biometric study.


METHODS
Two university hospitals, Switzerland.


METHODS
40 HIV-positive patients who had had CD4 counts done during the three months before operation.


METHODS
Clean and contaminated gastrointestinal and orthopaedic procedures.


METHODS
Postoperative infective complications.


RESULTS
15 patients developed postoperative infective complications (38%), 6 of which (40%) were HIV-related. CD4 cell count, as well as the type of operation (contaminated or clean), influenced the infective complication rate. The risk of infective complications after a contaminated procedure when the CD4 count was below 200 mm3 was more than 50%. In clean operations, even when the CD4 cell count was close to 0, the rate of infective complications was never as high as 50%. Patients with a CD4 cell count of 500 or more have a similar rate of infective complications as HIV seronegative patients.


CONCLUSIONS
Indications for operation in HIV-positive patients must take into account the CD4 cell count and the type of operation.
Department of Digestive Surgery, University Hospital, Geneva, Switzerland.
D
D
Savioz
M
M
Chilcott
C
C
Ludwig
M
M
Savioz
L
L
Kaiser
C
C
Leissing
L
L
Bühler
R
R
Peter
P
P
Morel
D000328:Adult; D018791:CD4 Lymphocyte Count; D013505:Digestive System Surgical Procedures; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D007239:Infections / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D011183:Postoperative Complications; D012189:Retrospective Studies