Preoperative CD4 Count or CD4/CD8 Ratio as a Useful Indicator for Postoperative Sepsis in HIV-Infected Patients Undergoing Abdominal Operations

Xia, Xianjun; Liu, Baochi; Jing, Su; Hui, Pei; Chen, Hui; Li, Lei; Liu, Yongfu

doi:10.1016/j.jss.2011.10.006

Cited by 29 publications

(28 citation statements)

References 37 publications

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“…The ratios of CD4+ T cell : CD8+ T cell are relatively lower in patients with sepsis, compared to non-sepsis patients [131, 132]. The results in Fig 15 show that in IMMABM there was a significantly lower CD4+ T cell : CD8+ T cell ratio when the HIR progressed to hyperinflammatory ( P = 0.0083) or organ dysfunction responses ( P = 0.0041) after 15 hours of infection.…”

Section: Resultsmentioning

confidence: 99%

“…The results in Fig 15 show that in IMMABM there was a significantly lower CD4+ T cell : CD8+ T cell ratio when the HIR progressed to hyperinflammatory ( P = 0.0083) or organ dysfunction responses ( P = 0.0041) after 15 hours of infection. Therefore, this basic clinical measure of T cell response [131, 132] also appears to be accurately reflected in the IMMABM.…”

Section: Resultsmentioning

confidence: 99%

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An Agent-Based Model of a Hepatic Inflammatory Response to Salmonella: A Computational Study under a Large Set of Experimental Data

et al. 2016

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We present an agent-based model (ABM) to simulate a hepatic inflammatory response (HIR) in a mouse infected by Salmonella that sometimes progressed to problematic proportions, known as “sepsis”. Based on over 200 published studies, this ABM describes interactions among 21 cells or cytokines and incorporates 226 experimental data sets and/or data estimates from those reports to simulate a mouse HIR in silico. Our simulated results reproduced dynamic patterns of HIR reported in the literature. As shown in vivo, our model also demonstrated that sepsis was highly related to the initial Salmonella dose and the presence of components of the adaptive immune system. We determined that high mobility group box-1, C-reactive protein, and the interleukin-10: tumor necrosis factor-α ratio, and CD4+ T cell: CD8+ T cell ratio, all recognized as biomarkers during HIR, significantly correlated with outcomes of HIR. During therapy-directed silico simulations, our results demonstrated that anti-agent intervention impacted the survival rates of septic individuals in a time-dependent manner. By specifying the infected species, source of infection, and site of infection, this ABM enabled us to reproduce the kinetics of several essential indicators during a HIR, observe distinct dynamic patterns that are manifested during HIR, and allowed us to test proposed therapy-directed treatments. Although limitation still exists, this ABM is a step forward because it links underlying biological processes to computational simulation and was validated through a series of comparisons between the simulated results and experimental studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

An Agent-Based Model of a Hepatic Inflammatory Response to Salmonella: A Computational Study under a Large Set of Experimental Data

et al. 2016

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“…Thirty-five HIV-infected patients undergoing abdominal operations with pre-operative CD4 <200 or CD4/CD8 ratio <0.15 had overall higher post-operative sepsis morbidity [13]. …”

Section: Discussionmentioning

confidence: 99%

Prospective cohort study of dental implant success rate in patients with AIDS

et al. 2016

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BackgroundOral health care of patients with acquired immune deficiency syndrome (AIDS) due to human immunodeficiency virus (HIV) is a growing area of concern, taking into consideration the increased life expectancy of patients resulting from antiretroviral therapy. There is insufficient literature regarding the impact of dental implants in AIDS patients. This study investigated the long-term clinical outcome of implant placement in patients diagnosed with AIDS.MethodsThis monocentric study included AIDS patients with CD4 <200 cells/μL, age 18 years or older, and a minimum of one edentulous space requiring implant. All patients in the study were undergoing highly active antiretroviral therapy (HAART). HAART includes nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs). Typical treatment includes two different NTRIs, along with a third drug, either an INSTI, a PI, or an NNRTI. Bicon dental implants were placed in the patients after medical clearance and were followed up for 5 years. Bicon system implants were chosen because of availability and previous experience with this brand. Implant success criteria are defined as implants that had no clinical mobility at uncovering, no radiographic radiolucency, and allowed for loading and abutment placement. Implant success in AIDS patients was measured over a period of 5 years. Descriptive statistics were used.ResultsSixteen adults met the inclusion criteria (12 males and 4 females) with mean CD4 count as 141.25 (sd 35.5). Thirty-three implants were placed in selected patients. Average time to uncovering was 151 days (sd 25 days). Two of the three failures were maxillary implants in the anterior arch, and the third was in the mandibular posterior arch.ConclusionsThe study found a slightly higher failure rate of 10 % in patients with AIDS, compared to widely accepted failure rates in healthy patients at 5–7 %. With the advent of new medical therapies, even AIDS patients should be offered the option of root-formed implants as a viable alternative to fixed and removable prosthetics.

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“…Post-operative infections occur more frequently in HIVinfected patients with CD4 counts <200 cell/ml, hypoalbuminemia, after major surgery or if there is a pre-existing infection at the surgical site [141,142]. At a tertiary referral center, it has been reported that 22% of HIV-infected elective hysterectomies result in a surgical site infection compared with 5% in the general population [143].…”

Section: Skin and Soft Tissue Infectionsmentioning

confidence: 99%

Management of severe non-TB bacterial infection in HIV-infected adults

Gaskell¹,

Feasey

Heyderman

2015

Expert Review of Anti-infective Therapy

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Despite widespread antiretroviral therapy use, severe bacterial infections (SBI) in HIV-infected adults continue to cause significant morbidity and mortality globally. Four main pathogens account for the majority of documented SBI: Streptococcus pneumoniae, non-typhoidal strains of Salmonella enterica, Escherichia coli and Staphylococcus aureus. The epidemiology of SBI is dynamic, both in developing countries where, despite dramatic successes in antiretroviral therapy, coverage is far from complete, and in settings in both resource-poor and resource-rich countries where antiretroviral therapy failure is becoming increasingly common. Throughout the world, this complexity is further compounded by rapidly emerging antimicrobial resistance, making management of SBI very challenging in these vulnerable patients. We review the causes and treatment of SBI in HIV-infected people and discuss future developments in this field.

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Preoperative CD4 Count or CD4/CD8 Ratio as a Useful Indicator for Postoperative Sepsis in HIV-Infected Patients Undergoing Abdominal Operations

Cited by 29 publications

References 37 publications

An Agent-Based Model of a Hepatic Inflammatory Response to Salmonella: A Computational Study under a Large Set of Experimental Data

An Agent-Based Model of a Hepatic Inflammatory Response to Salmonella: A Computational Study under a Large Set of Experimental Data

Prospective cohort study of dental implant success rate in patients with AIDS

Management of severe non-TB bacterial infection in HIV-infected adults

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