Infective Complications after Abdominal Surgery in Patients Infected with Human Immunodeficiency Virus: Role of CD4+ Lymphocytes in Prognosis

n= 8); (2) clean-contaminated: cholecystectomy and biliary tract surgery (n= 8); and (3) contaminated: appendectomy (n= 8). Depending on their CD4 count, two groups were formed: one with 200 to 500 cells/ml (n= 11) and the other with < 200 cells/ml (n= 13). When surgical infection was suspected, surgical drainage and microbiologic cultures were undertaken. For statistical evaluation of the groups ANOVA and the chi-square test were used; p < 0.05 was considered significant. Altogether 14 patients (58.3%) had a wound infection, and the mean (± SD) CD4 count in those patients was decreased (221.7 ± 75.1) compared with that of the 10 patients in the uneventful group (386 ± 81.2). Surgical infection rates were 50% for clean procedures, 62.5% for clean-contaminated procedures, and 62.5% for contaminated surgery. The group of patients with CD4 counts of < 200 cells/ml had an increased incidence of surgical infection, regardless of the type of surgery (p= 0.002). Thus the surgical infection rates in HIV patients undergoing abdominal surgery are dramatically increased. The CD4 and subsequently depressed neutrophil populations increase the risk of surgical infection during major procedures regardless of the type of surgery performed.