Background: Surgery affects immune function adversely in a variety of clinical settings. To date, there are no data assessing immune function in patients infected with the human immunodeficiency virus (HIV) who have had surgery.
Methods: A retrospective review was performed of 67 patients, of whom 46% were female, who underwent surgery while being treated for HIV infection. These patients were identified from a database collected over a ten-year period. The CD4+ cell counts were analyzed according to the degree of immunosuppression (≥500, 200–499, and <200 cells/mm3, respectively). Viral titers also were assessed.
Results: Of the 17 patients with CD4+ cell counts >500/mm3 prior to surgery, 64.7% had unchanged counts after surgery (95% confidence interval [CI] 32.9%, 81.6%), whereas 35.2% of patients had lower CD4+ counts after surgery (95% CI 14.2%, 61.7%). In patients with preoperative CD4+ counts between 200 and 500/mm3, 9.7% (95% CI 2.0%, 25.8%) had their counts decrease to <200 cells/mm3, whereas in 29% (95% CI 14.2%, 48.0%) of patients, the counts increased to within the normal range. In the most immunosuppressed group (CD4+ counts <200/mm3), 15.8% of patients (95% CI 3.4%, 39.6%) had their CD4+ counts increase to the intermediate range. In the majority of patients, the viral titers remained unchanged, whereas 18.8% (n = 6) (95% CI 7.2%, 36.4%) had a decline in their titers.
Conclusions: Surgery does not affect immune function adversely in HIV-infected patients, as judged by CD4+ cell counts or viral titers.
