BMC Infect Dis. 2026 May 3. doi: 10.1186/s12879-026-13413-4. Online ahead of print.
ABSTRACT
BACKGROUND: To explore whether preoperative CD4+ T-cell count is associated with postoperative infectious outcomes after endoscopic lithotripsy for upper urinary tract calculi in human immunodeficiency virus (HIV)-infected patients.
METHODS: The HIV-infected patients who underwent endoscopic lithotripsy for upper urinary tract stones at Shanghai Public Health Clinical Center from May 2019 to May 2025 were enrolled for this study. The exposure of interest was the preoperative peripheral blood CD4+ T-cell count. The primary endpoint was urosepsis. Secondary outcomes included postoperative fever, systemic inflammatory response syndrome (SIRS), and other postoperative complications.
RESULTS: A total of 120 patients were enrolled in this study, including 20 patients with a CD4+ T-cell count < 200 cells/µL and 100 patients with a CD4+ T-cell count ≥ 200 cells/µL. None of the patients developed urosepsis or SIRS postoperatively. The overall rate of postoperative fever was 17.5% (21/120). Fever was observed in 15.0% of the patients with a CD4+ T-cell count < 200 cells/µL, compared with 18.0% of those with a CD4+ T-cell count ≥ 200 cells/µL, and there was no statistically significant difference (P > 0.05). Logistic regression analysis further showed that CD4+ T-cell count was not significantly associated with fever (OR = 1.001, 95% CI: 0.998-1.003, P = 0.586), whereas urine white blood cell count, stone density, and surgical approach were independently associated with fever. Sensitivity analyses using propensity score matching and inverse probability of treatment weighting showed similar results.
CONCLUSION: In this retrospective single-center cohort, preoperative CD4+ T-cell count was not significantly associated with postoperative fever after endoscopic lithotripsy in HIV-infected patients. However, because no urosepsis events occurred and the sample size, particularly in the CD4+ T-cell count < 200 cells/µL subgroup, was limited, the study could not adequately evaluate the primary endpoint. These findings should therefore be considered exploratory and require confirmation in larger studies incorporating HIV viral load and procedure-specific analyses.
PMID:42071191 | DOI:10.1186/s12879-026-13413-4
