Pulmonary resection for lung cancer in HIV-positive patients with low (< 200 lymphocytes/mm(3)) CD4(+) count

The clinical improvement obtained with combination treatment has modified t he therapeutic approach of lung cancer in HIV-positive patients. Aggressive surgical treatment has become a viable option for those patients in whom t he CD4(+) cell count was greater than 200 lymphocytes/mm(3). We recently ex tended our surgical indications to include two HIV-positive patients with l ung cancer (stage IIIA and IIB) and low (< 200 lymphocytes/mm3) CD4(+) coun t. Both patients underwent a lobectomy and mediastinal nodal dissection. Th e postoperative course was uneventful. No evidence of recurrent cancer was seen at 12 and 20 months after the operation. Based on this limited experie nce, we conclude that a low CD4(+) count should not represent, per se, an e xclusion criterion for the surgical treatment of pleuropulmonary conditions in HIV-positive patients. (C) 2000 Elsevier Science Ireland Ltd. All right s reserved.