Correlation analysis of compromised immune function with perioperative sepsis in HIV-positive patient

Baochi Liu, Meng Wang, Jinsong Su, Yanzheng Song, Li Liu, Lei Li

Department of Surgery, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai, China.

DOI: 10.4236/health.2012.44028                

Abstract

Objective: To investigate the relationship between immune function and perioperative sepsis in HIV-positive patients. Methods: Retrospective analysis of 144 HIV-positive patients surgically treated from Oct 2008 to Dec 2010 in Shanghai Public Health Clinical Center. The patients were divided into four groups based on their CD4⁺ T cells counts in preoperative period: group A (0 – 99 cell/ul), group B (100 – 199 cell/ul)，group C (200 – 349 cell/ul)，group D (≥350 cell/ul). All patients had received standardized surgical procedures, careful surgical routines were applied. To reduce operational damage, conventional antibi-otics, anti-TB, anti-fugal, antiretroviral therapies were used to prevent infection and promptly treatment of complications. Results among 144 HIV-positive patients (male 133 and female 11, aged 42.6 ± 12.5), 80 patients got perioperative sepsis (14 cases in preoperative period and 66 cases in postoperative period). 64 cases did not get sepsis. The average CD4⁺ T cell count was 276.97 ± 137.91 in preoperative period of patients without sepsis, which was significant higher than the patients with preoperative sepsis (151.29 ± 110.64) and patients with postope- rative sepsis(161.14 ± 128.45) (F = 13.91, P < 0.05). There were statistic differences of perioperative sepsis among A group (82.6%), B group (69.8%), C group (40.5%) and D group (26.9%) (χ² = 23.680, P < 0.01). Three cases died of MODS in group A , each one died of MODS in group B and group C. There was no death in group D. There was negative correlation between the incidence of sepsis and levels of CD4⁺T cells (r = –0.987, P = 0.013). Conclusions With the decrease of preoperative CD4⁺T cells, the risk of perioperative sepsis had notable increase. Complete evaluation of surgical risk and suitable perioperative treatments may obtain better effect for the patients infected HIV.

Keywords

HIV; Acquired Immunodeficiency Syndrome; Sepsis; Surgical Operation

Conflicts of Interest

The authors declare no conflicts of interest.

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