Impact of laparoscopic cholecystectomy on cellular immunity in patients with HIV infection

Aim: To observe the impact of laparoscopic cholecystectomy (LC) on cellular immunity in HIVinfected patients with different levels of immunodeficiency. Methods: Ninety-four patients who underwent LC, including 62 HIV-positive (HIV+) patients and 32 randomly selected HIV-negative (HIV-) patients, were included in the study. Peripheral venous blood samples were collected to count the number of CD4+ (cell/��L) and CD8+ (cell/��L) T lymphocyte subsets on preoperative day 1 (D0) and postoperative days 3 (D3) and 7 (D7). The ratios of the number of CD4+ cells on D3 to that on D0 [D3/D0 (%)] and D7 to D0 [D7/ D0 (%)] were calculated. Patients were stratified into three groups according to the count of CD4+ cell count on D0: I(�� 500), II (�� 200 but < 500) and III (�� 0 but < 200). The differences in the cell count between preoperation and postoperation in each group and between each group were analyzed by statistical methods. Results: There were no significant differences in WBC count, neutrophil percentage, lymphocyte percentage and CD8+ cell count between preoperation and postoperation in each group (P > 0.05 for all), but significant differences were observed in CD4+ cell count between preoperation and postoperation in each group (P < 0.001 for all) as well as between different groups (F = 203.80, P < 0.001). There was an interactive effect between time and group (F = 8.08, P < 0.001). Conclusion: LC has an impact on CD4-based cellular immunity, with a process from suppression to restoration. The more serious the immunodeficiency, the more significant the immunosuppression and the more slow the immune recovery. Attention should be paid to surgical indications and appropriate perioperative management including immune intervention in HIVinfected patients undergoing surgery. ? 2014 Baishideng Publishing Group Co., Limited. Allrights reserved.