In planning elective foot/ankle procedures for an HIV-positive patient, the CD4 threshold to proceed with surgery is?

In planning elective foot/ankle procedures for an HIV-positive patient, the CD4 threshold to proceed with surgery is?

• A. 150 cells per microliter
• B. 200 cells per microliter
• C. 250 cells per microliter
• D. 300 cells per microliter

Answer: (B)

The level of immune function, as shown by the CD4 count, drives how safely an elective foot/ankle operation can be performed in an HIV-positive patient. When the CD4 count falls to 200 cells per microliter or lower, the risk of serious opportunistic infections, like Pneumocystis jirovecii pneumonia, increases markedly, and the body’s ability to heal after surgery is compromised. Because of these risks, elective procedures are typically planned only after the CD4 count has reached about 200 cells/µL and the patient is on effective antiretroviral therapy with good overall health. This threshold helps balance the need for surgical care with the patient’s recovery capacity. Counts above 200 are generally safer, though individual factors such as viral load, nutrition, comorbidities, and the specific procedure still influence perioperative planning.