Effect of emergency major abdominal surgery on CD4 cell count among HIV positive patients in a sub Saharan Africa tertiary hospital - a prospective study
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Date
2013
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMC surgery
Abstract
Surgery plays a key role in HIV palliative care, specifically in the diagnosis and treatment of HIV
related and non-related conditions. Yet major surgery depresses the immune system. Whereas the surgical
consequences of HIV infection are well described, there is a paucity of published data, in resource-limited settings,
on the effects of major surgery on the immune system. The purpose of this study was to determine the effect of
major abdominal surgery on CD4 count in HIV positive and HIV negative patients after emergency major surgery.
Methods: A prospective cohort study was done for patients who underwent emergency major abdominal surgery.
Their peri-operative CD4 counts were done for both HIV- and HIV + patients. Median CD4s were used in analysis.
Mann Whitney test of significance was used for continuous data and Fisher’ exact test used for categorical data. IRB
approval was obtained.
Results: A total of 101 patients were recruited, 25 HIV positive and 76 HIV negative. The median CD4 cell reduction
was higher in the HIV negative group (−68 cells) than HIV positive group (−29 cells) (p = 0.480).
There was a general increase in the median CD4 change by 72 cells for the HIV positives and 95 cells for the HIV
negatives (p = 0.44). CD4 change rose in both the HIV positive and negative groups by 27 cells for the HIV positives
and 28 cells for the HIV negatives (p = 0.94). Relative Risk was 0.96, {CI 0.60 – 1.53}.
Conclusion: Major emergency abdominal surgery had no significant effect on CD4 cell count among HIV positive
patients.
Description
Keywords
Major surgery, CD4, HIV
Citation
Okumu, G., Makobore, P., Kaggwa, S., Kambugu, A., & Galukande, M. (2013). Effect of emergency major abdominal surgery on CD4 cell count among HIV positive patients in a sub Saharan Africa tertiary hospital-a prospective study. BMC surgery, 13(1), 1-7.