J Acquir Immune Defic Syndr. 1989;2(1):43-53. Unique Identifier :
People with human immunodeficiency virus disease (HIVD) frequently
present to surgical services for consideration of surgical therapies.
They may be counseled by physicians who introduce into the
decision-making process their personal fear of contagion, uncertainty
about potential therapeutic benefits of surgery for people with HIVD,
and anecdotal impressions that the immunodeficiency of HIVD might be
accelerated by surgical and anesthetic interventions. However, there are
no studies that have investigated immunomodulating effects of surgery
and anesthesia in people with HIVD. Also, clinical studies of surgical
interventions in populations of people with HIVD do not clearly
demonstrate adverse outcomes attributable to surgery alone. Review of
immunomodulating effects of surgical procedures in populations of people
without HIVD reveals that multiple alterations of immune parameters may
occur in response to all phases of anesthesia, surgery, and
postoperative recovery. These alterations often depend upon the type of
anesthesia used and the degree of surgical trauma. Most notably, the
alterations are transient and rarely correlated with adverse clinical
outcomes. These facts mitigate against the current preconceived notion
that surgery will superimpose a sustained and clinically significant
detriment to the immunologic competence of people with HIVD. A proposal
for rational exploration and study of this issue is presented.
Acquired Immunodeficiency Syndrome/*IMMUNOLOGY/MORTALITY/ TRANSMISSION
Anesthesia/ADVERSE EFFECTS B-Lymphocytes/CLASSIFICATION Human
Hypersensitivity, Delayed Killer Cells, Natural/IMMUNOLOGY Leukocyte
Count Lymphocyte Transformation Neutrophils/IMMUNOLOGY Postoperative
Complications *Surgery, Operative/ADVERSE EFFECTS
T-Lymphocytes/CLASSIFICATION JOURNAL ARTICLE