Effect of surgical infection control during perioperative period in patients with acquired immunodeficiency syndrome complicated with cataract after systemic highly effective antiretroviral therapy

doi:10.3877/cma.j.issn.1674-1358.2019.05.015

Abstract

Abstract:

Objective

To investigate the effect of surgical infection control during perioperative period after systemic highly effective antiretroviral therapy (HAART) in patients with acquired immunodeficiency syndrome (AIDS) complicated with cataract.

Methods

The basic data of 10 patients with AIDS complicated with cataract before and after operation collected from Beijing Ditan Hospital, Capital Medical University were analyzed, retrospectively.

Results

After systemic highly effective antiretroviral therapy (HAART) for 10 cases with AIDS and cataract, the CD4⁺ T lymphocyte count increased to 196-745 cells/μl, witout complications. Eight patients received cataract phacoemulsification combined with intraocular lens implantation. One patient was complicated with macular membrane, and the other one was complicated with retinal detachment. Both the two cases were treated with vitrectomy combined with phacoemulsification and intraocular lens implantation. No infection occurred in all 10 patients with AIDS complicated with cataract.

Conclusions

HAART for AIDS patients with cataract before surgery, strict preoperative disinfection, intraoperative aseptic operation, postoperative observation and dressing change could effectively prevent the occurrence of postoperative infection in AIDS patients complicated with cataract.

Key words: Acquired immunodeficiency syndrome, Cataract, Perioperative period, Infection prevention and control

Xuejing Xu, YueHong Liu, Binbin Liu, Yu Dong, Aimin Ma, Ning Chen. Effect of surgical infection control during perioperative period in patients with acquired immunodeficiency syndrome complicated with cataract after systemic highly effective antiretroviral therapy[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(05): 432-435.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-1358.2019.05.015

https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/Y2019/V13/I05/432

Figures/Tables 1

References 19

[1]	孙挥宇,毛菲菲,李丹. 医学科普教育中AIDS知识的普及教育[J/CD]. 中华实验和临床感染病杂志:电子版,2014,8(5):719-720.
[2]	李帅飞,陈彬川,雷方, 等. 超声乳化针头影响白内障超声乳化吸出术效率和安全性研究进展[J]. 眼科新进展,2016,36(1):88-91．
[3]	Russell JA. Management of sepsis[J]. N Engl J Med,2006,355(16):1699-1713.
[4]	Greenberg JA,Lennox JL,Martin GS. Outcomes for critically ill patients with HIV and severe sepsis in the era of hihly active antiretroviral therapy[J]. J Crit Care,2012,27(1):51-57
[5]	Dellinger RP,Levy MM,Carlet JM, et al. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock: 2008[J]. Intensive Care Med,2008,34(1):17-60.
[6]	Grulich AE,van Leeuwen MT,Faleter MO, et al. Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: A meta-analysis[J]. Lancet,2007,370(9581):59- 67.
[7]	Bele N,Darmon M,Coquet I, et al. Diagnostic accuracy of Prcalcitonin in critically ill immunocompromised patients[J]. BMC Infect Dis,2011,11(1):224.
[8]	Riva S,Bullinger M,Amann E, et al. Content comparison of haemophilia specific patient-rated outcom measures with the international classification of functioning,disability and health (ICF, ICF-CY) [J]. Health Qual Life Outcomes,2010,8(1):139-153.
[9]	Guidelines for the antiretroviral agents in HIV-1 infected adults and adoles and adolescens. Developed by the panel on clinical practices for Treatment of HIV Infection convened by the Department of Health and Human Services (DHHS)[J]. MMWR Recomm Rep,1998,47(RR-5):43-82.
[10]	Kaufmann GR,Perrin L,Pantaleo G, et al. CD4⁺ T-lymphocyte recovery in individuals with advanced HIV-1 infection receiving potent antiretoviral therapy for 4 years: the Swiss HIV Cohort Study[J]. Arch Intern Med,2003,163(18):2187-2195
[11]	刘彦春. HIV/AIDS患者的临床流行病学特征、皮肤表现特点及与免疫状态和病毒载量的相关性研究[D]. 北京: 北京大学,2008.
[12]	Hájek M,Novák K,Zikmundová K. Surgey-related death, complicated wounds, and anastomosis healing in HIV-positive patients with considerable immune deficit: assumption and reality[J]. Int Surg,2009,94(3):228-236.
[13]	Deneve JL,Shantha JG,Page AJ, et al. CD4 count is predietive of outcome in HIV-positive patients undergoing abdominal operations[J]. Am J Surg,2010,200(6):694-700.
[14]	张慧,崔巍. 硬核白内障手术治疗的临床研究进展[J]. 国际眼科杂志,2016,16(5):856-858．
[15]	伦文辉. AIDS的抗病毒治疗[J]. 继续医学教育,2006,20(7):68-71.
[16]	Mc Nabb J,Ross JW,Abriola K, et al. Aherence to highly active antiretroviral therapy predicts vriologic outcome at an inner-city human immunodeficiency virus clinic[J]. Clin Infect Dis,2001,33(5):700-705.
[17]	Xia XJ,Liu BC,Su JS, et al. Preoperative CD4 count or CD4/CD8 ratio as a useful indicator for postoperative spsis in HIV-infected patients undergoing abdominal operations[J]. J Surg Res,2012,174(1):25-30.
[18]	Broder S. The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic[J]. Antiviral Res,2010,85(1):1-18.
[19]	Gasnault J,Costagliola D,Hendel Chavez H, et al. Improved survival of HIV-1-infected patients with progressive multifocal leukoencephalopathy receiving early 5-drug combination antiretroviral therapy[J]. PLoS One,2011,6(6):e20967.

序号	性别	年龄	HIV RNA(拷贝/ml）	CD4⁺ T淋巴细胞（个/μl）	TPPA	视力
序号	性别	年龄	HIV RNA(拷贝/ml）	CD4⁺ T淋巴细胞（个/μl）	TPPA	术前视力	术后第1天	术后第7天	术后1个月
1	男	35	< 40	196	（－）	0.25/0.25	0.5/0.5	0.6/0.6	0.8/1.0
2	男	64	（－）	236	（－）	手动	0.25	0.3	0.6
3	男	41	（－）	342	（－）	指数	0.8	0.8	0.8
4	男	52	（－）	399	（－）	0.04	0.8	0.8	1.0
5	男	32	（－）	399	（+）	指数	指数	指数	指数
6	女	64	（－）	419	（－）	0.3	0.6	0.6	0.8
7	男	58	（－）	441	（－）	手动	手动	手动	手动
8	男	52	（－）	512	（+）	指数	0.8	0.8	0.8
9	女	75	13 233	745	（－）	0.3/0.3	0.8/0.8	0.8/1.0	1.2/1.2
10	男	69	（－）	480	（－）	0.15	0.6	0.6	0.8

序号	性别	年龄	HIV RNA(拷贝/ml）	CD4⁺ T淋巴细胞（个/μl）	TPPA	视力
序号	性别	年龄	HIV RNA(拷贝/ml）	CD4⁺ T淋巴细胞（个/μl）	TPPA	术前视力	术后第1天	术后第7天	术后1个月
1	男	35	< 40	196	（－）	0.25/0.25	0.5/0.5	0.6/0.6	0.8/1.0
2	男	64	（－）	236	（－）	手动	0.25	0.3	0.6
3	男	41	（－）	342	（－）	指数	0.8	0.8	0.8
4	男	52	（－）	399	（－）	0.04	0.8	0.8	1.0
5	男	32	（－）	399	（+）	指数	指数	指数	指数
6	女	64	（－）	419	（－）	0.3	0.6	0.6	0.8
7	男	58	（－）	441	（－）	手动	手动	手动	手动
8	男	52	（－）	512	（+）	指数	0.8	0.8	0.8
9	女	75	13 233	745	（－）	0.3/0.3	0.8/0.8	0.8/1.0	1.2/1.2
10	男	69	（－）	480	（－）	0.15	0.6	0.6	0.8

Please choose a citation manager

Content to export