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Preoperative counts of CD4 T-lymphocytes and early postoperative infective complications in HIV-positive patients.
Savioz D; Chilcott M; Ludwig C; Savioz M; Kaiser L; Leissing C; Buhler
December 30, 1998
Eur J Surg. 1998 Jul;164(7):483-7. Unique Identifier : AIDSLINE

OBJECTIVE: To assess the relationship between postoperative infective complications and the CD4 count. DESIGN: Retrospective and biometric study. SETTING: Two university hospitals, Switzerland. SUBJECT: 40 HIV-positive patients who had had CD4 counts done during the three months before operation. INTERVENTIONS: Clean and contaminated gastrointestinal and orthopaedic procedures. MAIN OUTCOME MEASURE: 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. CONCLUSION: Indications for operation in HIV-positive patients must take into account the CD4 cell count and the type of operation.

JOURNAL ARTICLE Adult *CD4 Lymphocyte Count Female Gastrointestinal System/SURGERY Human HIV Seropositivity/*COMPLICATIONS Infection/*ETIOLOGY Male Middle Age Orthopedic Procedures Postoperative Complications Retrospective Studies