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


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.

Share and Cite:

Liu, B. , Wang, M. , Su, J. , Song, Y. , Liu, L. and Li, L. (2012) Correlation analysis of compromised immune function with perioperative sepsis in HIV-positive patient. Health, 4, 190-195. doi: 10.4236/health.2012.44028.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Moore, C.C., Jacob, S.T., Pinkerton, R., et al. (2008) Point-of-care lactate testing predicts mortality of severe sepsis in a predominantly HIV type 1—Infected patient popula-tion in Uganda. Clinical Infectious Diseases, 46, 215-222. doi:10.1086/524665
[2] Zaidi, A.K., Ganatra, H.A., Syed, S., et al. (2011) Effect of case management on neonatal mortality due to sepsis and pneumonia. BMC Public Health, 11, 13. doi:10.1186/1471-2458-11-S3-S13
[3] Levinson, A.T., Casserly, B.P. and Levy, M.M. (2011) Reducing mortality in severe sepsis and septic shock. Seminars in Respiratory and Critical Care Medicine, 32, 195- 205. doi:10.1055/s-0031-1275532
[4] Lagu, T., Rothberg, M.B., Nathanson, B.H., et al. (2011) The relationship between hospital spending and mortality in patients with sepsis. Archives of Internal Medicine, 171, 292-299. doi:10.1001/archinternmed.2011.12
[5] Levy, M.M., Fink, M.P., Marshall, J.C., et al. (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Critical Care Medicine, 31, 1250-1256. doi:10.1097/01.CCM.0000050454.01978.3B
[6] Jeremiah, L. Deneve, D.O., Jessica, G., et al. (2010) CD4 count is predictive of outcome in HIV-positive patients undergoing abdominal operations. American Journal of Surgery, 200, 694-700. doi:10.1016/j.amjsurg.2010.07.030
[7] Pereyra, F., Palmer, S., Miura, T., et al. (2009) Persistent low-level viremia in HIV-1 elite controllers and relationship to immunologic parameters. Journal of Infectious Diseases, 200, 984-990. doi:10.1086/605446
[8] Jain, S.B., Wig, N., Nagpal, S.J., et al. (2011) Evaluation of the current management protocols for prophylaxis against Pneumocystis jiroveci pneumonia and other opportunistic infections in patients living with HIV/AIDS. AIDS Care, 23, 1-5. doi:10.1080/09540121.2010.542129
[9] Sax, P.E., Sloan, C.E., Schackman, B.R., et al. (2010) Early antiretroviral therapy for patients with acute aidsrelated opportunistic infections: A cost-effectiveness analysis of ACTG A5164. HIV Clinical Trials, 11, 248-259. doi:10.1310/hct1105-248
[10] Kulkarni, S.V., Kairon, R., Sane, S.S., et al. (2009) Opportunistic parasitic infections in HIV/AIDS patients presenting with diarrhoea by the level of immunesuppression. Indian Journal of Medical Research, 130, 63-66.
[11] Hocqueloux, L., Prazuck, T., Avettand-Fenoel, V., et al. (2010) Long-term immunovirologic control following antiretroviral therapy interruption in patients treated at the time of primary HIV-1 infection. AIDS, 24, 1598-1601. doi:10.1097/QAD.0b013e32833b61ba
[12] Lemma, M., Vanelli, P., Beretta, L., et al. (1992) Cardiac surgery in HIV-positive intravenous drug addicts: Influence of cardiopulmonary bypass on the progression to AIDS. Journal of Thoracic and Cardiovascular Surgery, 40, 279- 282. doi:10.1055/s-2007-1022720
[13] Fasan, M.L., Morandi, E., Fociani, P., et al. (2003) AIDS-associated gastrointestinal lymphoma: Is there a role for surgery in the standard of care? Journal of Acquired Immune Deficiency Syndromes, 34, 345-347. doi:10.1097/00126334-200311010-00015

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.