Abstract: Objective To analyze the correlation between CD4+T lymphocyte count and postoperative pulmonary complications (including bacterial pneumonia, fungal pneumonia, pleuritis, pleural effusion, respiratory failure and other serious adverse events in the lungs) in patients with HIV infection who underwent cholecystectomy. The aim is to provide a reference for reducing postoperative pulmonary complications and optimizing perioperative management in HIV-infected patients. Method A retrospective analysis was conducted on the clinical data of 122 HIV-infected patients who underwent cholecystectomy at the Chengdu Public Health Clinical Medical Center between June 2017 and November 2024. Logistic regression analysis was used to evaluate the correlation between CD4+T cell count and postoperative pulmonary complications. Result Among the 122 HIV-infected patients, 53（43.44%）were female and 69 （56.56%）were male, with an average age of (50.24±11.97) years. The median CD4+T cell count was 366 (246, 481) cells/µl, and the incidence of postoperative pulmonary complications was 16.39%. Statistically significant association was observed between CD4+T cell count and postoperative pulmonary complications (OR=0.996, 95%CI：0.993-0.999,P=0.021), further stratified analysis revealed significant findings. Using HIV-infected patients with CD4+T cell counts <200 cells/µl as the reference group, those with CD4+T cell counts ≥500 cells/µl demonstrated a negative correlation with postoperative pulmonary complications (OR=0.154, 95%CI：0.028-0.843,P=0.031). This negative association persisted after adjusting for confounding factors (OR=0.169, 95%CI：0.029-0.997,P<0.050). Conclusion The risk of pulmonary complications after cholecystectomy in HIV-infected patients was lower when the CD4+T lymphocyte count was ≥500 cells/µl. Effective antiviral therapy should be administered to HIV-infected patients to maintain adequate CD4+T lymphocyte count and and thereby reduce the risk of postoperative pulmonary complications.

Key words: CD4+T lymphocytes, HIV infection, Cholecystectomy, Postoperative pulmonary complications, Correlation study