Which CD4 count is the correct minimum safe level for elective foot/ankle surgery?

Which CD4 count is the correct minimum safe level for elective foot/ankle surgery?

• A. 150 cells per microliter
• B. 180 cells per microliter
• C. 200 cells per microliter
• D. 250 cells per microliter

Answer: (C)

Immune competence, as shown by the CD4 count, directly affects the risk of infection and wound healing after foot and ankle surgery. When the CD4 count is around 200 cells per microliter or lower, the risk of opportunistic infections and poor healing rises significantly. For elective procedures, a practical safety threshold is to have a CD4 count at or above about 200 cells/µL. This level is associated with a lower perioperative infection risk and better healing than counts below it. Of course, CD4 count is not the sole determinant—antiretroviral therapy, viral load, nutrition, and other health factors also play important roles in surgical risk and healing. If the count is below this threshold, surgeons typically consider delaying elective surgery or optimizing the patient’s immune status before proceeding.

Immune competence, as shown by the CD4 count, directly affects the risk of infection and wound healing after foot and ankle surgery. When the CD4 count is around 200 cells per microliter or lower, the risk of opportunistic infections and poor healing rises significantly. For elective procedures, a practical safety threshold is to have a CD4 count at or above about 200 cells/µL. This level is associated with a lower perioperative infection risk and better healing than counts below it. Of course, CD4 count is not the sole determinant—antiretroviral therapy, viral load, nutrition, and other health factors also play important roles in surgical risk and healing. If the count is below this threshold, surgeons typically consider delaying elective surgery or optimizing the patient’s immune status before proceeding.