Increase in CD4 Lymphocyte Counts After Splenectomy in HIV‐Infected Patients
作者:
ALLAN TUNKEL,
BRIAN KELSALL,
MICHAEL REIN,
DONALD INNES,
FRANK SAULSBURY,
KELLY VOLLMER,
BRIAN WISPELWEY,
期刊:
The American Journal of the Medical Sciences
(OVID Available online 1993)
卷期:
Volume 306,
issue 2
页码: 105-110
ISSN:0002-9629
年代: 1993
出版商: OVID
关键词: CD4 lymphocytes;Splenectomy;Thrombocytopenia;Human immunodeficiency virus type 1.
数据来源: OVID
摘要:
The records were reviewed of five human immunodeficiency virus (HIV) type 1-infected patients who underwent splenectomy, four for HIV-associated thrombocytopenia and one for gastric compression secondary to splenomegaly. After splenectomy, the four adult patients all had marked, sustained increases in their absolute CD4 lymphocyte counts; greater increases were observed in CD8 lymphocyte counts, accounting for decreases in the CD4:CD8 ratios. In patient 5 (one of triplets, all of whom were infected with HIV after a blood transfusion), absolute CD4 lymphocyte counts were stabilized after splenectomy; the other siblings manifested a decline in CD4 counts, which was associated with a delay in physical development and recurrent episodes of varicella. Immunohistochemical staining of spleen sections demonstrated significantly higher numbers of CD4 cells in splenic tissue from HIV-infected patients than from patients splenectomized secondary to trauma (2,070 ± 284 vs. 962 ± 296; p = 0.025). In addition, the HIV-infected patients had significantly higher percentages of CD4 lymphocytes in splenic tissue than in peripheral blood (49.3 ± 11.0 vs. 20.3 ± 7.9; p = 0.005), suggesting that CD4 cells were sequestered in the spleens of these patients. These findings have implications for the management of splenectomized HIV-infected patients with regard to optimal timing of initiation of zidovudine therapy and for prophylaxis ofPneumocystis cariniipneumonia.
点击下载:
PDF
(662KB)
返 回