Document 0700
 DOCN  M9490700
 TI    CD4 lymphocyte numbers after splenectomy in patients infected with the
       human immunodeficiency virus.
 DT    9411
 AU    Fairley CK; Spelman D; Street A; Jennens ID; Spicer WJ; Crowe S;
       Department of Social and Preventive Medicine, Alfred Hospital,; Prahran,
       Victoria, Australia.
 SO    Int J STD AIDS. 1994 May-Jun;5(3):177-81. Unique Identifier : AIDSLINE
       MED/94339219
 AB    Splenectomy has been reported to alter inconsistently the CD4 lymphocyte
       numbers in patients infected with the human immunodeficiency virus
       (HIV). To further assess the effect of splenectomy we have
       retrospectively examined the charts of 10 patients who were infected
       with HIV and who had undergone splenectomy. There was a significant
       increase in the mean CD4 numbers following splenectomy (mean increase of
       326/microliters, or 2.1-fold, P = 0.0009), the total lymphocyte numbers
       (mean increase of 1.55/ml, or 2.2-fold, P = 0.001) and in the CD8
       lymphocyte count (mean increase of 968/microliters, or 2.3-fold, P =
       0.014). No significant difference was observed in the percentage CD4
       lymphocytes (P = 0.95) or in the CD4:CD8 lymphocyte ratio (P = 0.76). In
       two patients, symptoms suggestive of impaired immune function developed
       post-splenectomy, at a time when their CD4 lymphocyte numbers were
       markedly higher than their pre-splenectomy values. One developed oral
       candidiasis (CD4 960/microliters, percentage CD4 32%), and in one
       patient a 7 kg weight loss was associated with recurrent mouth ulcers
       (CD4 680/microliters, percentage CD4 7%). We conclude that the total CD4
       count increases significantly after splenectomy while the percentage CD4
       lymphocyte count and CD4:CD8 lymphocyte ratio do not. Our data suggest
       that the CD4 lymphocyte count overestimates the immune function in these
       patients, although our findings are not conclusive.
 DE    CD4-CD8 Ratio  Human  HIV Infections/BLOOD/*IMMUNOLOGY/SURGERY
       Leukocyte Count  Retrospective Studies  *Splenectomy  Support, Non-U.S.
       Gov't  *T4 Lymphocytes  JOURNAL ARTICLE

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